| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,890 |
3,192 |
$407K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,821 |
4,518 |
$399K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,740 |
1,447 |
$145K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,051 |
835 |
$90K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
943 |
793 |
$77K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
3,364 |
2,287 |
$48K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
461 |
325 |
$38K |
| 87276 |
|
2,325 |
1,527 |
$28K |
| 87275 |
|
2,323 |
1,529 |
$23K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
1,586 |
1,011 |
$22K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,310 |
994 |
$16K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
714 |
541 |
$15K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
337 |
272 |
$11K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
379 |
297 |
$10K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
41 |
29 |
$5K |
| A4617 |
Mouth piece |
1,456 |
905 |
$5K |
| 87807 |
|
417 |
283 |
$5K |
| A4616 |
Tubing (oxygen), per foot |
1,457 |
904 |
$4K |
| 88738 |
|
549 |
506 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
236 |
165 |
$2K |
| 90670 |
|
58 |
46 |
$1K |
| 81002 |
|
354 |
326 |
$1K |
| 90734 |
|
59 |
40 |
$1K |
| 94760 |
|
473 |
378 |
$720.48 |
| 90707 |
|
50 |
37 |
$692.59 |
| 90633 |
|
71 |
55 |
$431.54 |
| 90702 |
|
59 |
53 |
$373.22 |
| 90649 |
|
40 |
27 |
$167.39 |
| 90461 |
|
70 |
41 |
$145.16 |
| 90715 |
|
31 |
27 |
$143.16 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
98 |
83 |
$3.53 |
| J7609 |
Albuterol, inhalation solution, compounded product, administered through dme, unit dose, 1 mg |
108 |
61 |
$0.00 |
| 90698 |
|
20 |
13 |
$0.00 |
| 90716 |
|
19 |
13 |
$0.00 |