| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,336 |
2,844 |
$120K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,231 |
1,169 |
$17K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
164 |
160 |
$15K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
878 |
705 |
$10K |
| 99091 |
|
61 |
58 |
$9K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
305 |
155 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
28 |
27 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
26 |
25 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
126 |
118 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
27 |
25 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
60 |
58 |
$853.53 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
101 |
92 |
$615.50 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
16 |
13 |
$558.39 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
261 |
249 |
$446.96 |
| 99406 |
|
75 |
61 |
$365.85 |
| 90686 |
|
77 |
74 |
$125.62 |
| 90461 |
|
15 |
13 |
$109.27 |
| 90651 |
|
47 |
47 |
$80.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
15 |
13 |
$13.52 |
| 3008F |
|
3,478 |
2,951 |
$0.00 |
| 1125F |
|
555 |
519 |
$0.00 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
960 |
862 |
$0.00 |
| 1036F |
|
1,724 |
1,379 |
$0.00 |
| 3074F |
|
54 |
44 |
$0.00 |
| 90620 |
|
13 |
12 |
$0.00 |
| 3079F |
|
32 |
30 |
$0.00 |
| 91301 |
|
19 |
19 |
$0.00 |
| 4000F |
|
14 |
12 |
$0.00 |
| 0521F |
|
583 |
541 |
$0.00 |
| 1160F |
|
1,548 |
1,249 |
$0.00 |
| 1159F |
|
1,552 |
1,249 |
$0.00 |
| 3077F |
|
25 |
24 |
$0.00 |
| 3725F |
|
100 |
91 |
$0.00 |
| 90734 |
|
13 |
12 |
$0.00 |