| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,586 |
3,754 |
$206K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,054 |
1,768 |
$116K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,542 |
1,223 |
$32K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
3,035 |
1,197 |
$28K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
2,030 |
1,604 |
$19K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
979 |
733 |
$15K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
207 |
164 |
$15K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,007 |
821 |
$14K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
209 |
165 |
$13K |
| 92552 |
|
488 |
405 |
$10K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
511 |
400 |
$9K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
93 |
78 |
$7K |
| 85018 |
|
1,260 |
1,003 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
30 |
25 |
$3K |
| 36415 |
Collection of venous blood by venipuncture |
1,725 |
1,508 |
$3K |
| 36416 |
|
1,390 |
1,085 |
$2K |
| 99173 |
|
350 |
292 |
$2K |
| 81003 |
|
991 |
778 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
15 |
15 |
$847.29 |
| 87807 |
|
82 |
62 |
$707.16 |
| 90674 |
|
99 |
70 |
$663.95 |
| 90670 |
|
108 |
87 |
$440.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
221 |
172 |
$389.35 |
| 90716 |
|
17 |
17 |
$150.00 |
| 90707 |
|
14 |
14 |
$92.00 |
| 86580 |
|
69 |
40 |
$83.96 |
| G0008 |
Administration of influenza virus vaccine |
59 |
37 |
$46.02 |
| 90633 |
|
14 |
14 |
$44.21 |
| 90648 |
|
106 |
85 |
$42.46 |
| 90696 |
|
13 |
13 |
$35.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
53 |
44 |
$18.86 |
| 90688 |
|
107 |
97 |
$0.00 |
| 90686 |
|
15 |
12 |
$0.00 |
| 90723 |
|
39 |
30 |
$0.00 |
| 90681 |
|
15 |
12 |
$0.00 |