| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
7,070 |
5,998 |
$449K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,734 |
1,591 |
$155K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,054 |
1,044 |
$95K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
921 |
914 |
$84K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,434 |
2,406 |
$83K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
854 |
807 |
$74K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
644 |
634 |
$62K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
3,581 |
3,524 |
$34K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
2,237 |
2,205 |
$23K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
1,535 |
1,165 |
$22K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,195 |
1,103 |
$13K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
242 |
220 |
$12K |
| G0299 |
Direct skilled nursing services of a registered nurse (rn) in the home health or hospice setting, each 15 minutes |
95 |
38 |
$8K |
| 99173 |
|
410 |
409 |
$8K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
284 |
281 |
$5K |
| 92551 |
|
373 |
372 |
$4K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
24 |
24 |
$3K |
| 99188 |
|
77 |
77 |
$2K |
| 99383 |
|
13 |
13 |
$1K |
| 99381 |
|
13 |
12 |
$1K |
| 81002 |
|
278 |
267 |
$728.96 |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
51 |
49 |
$332.39 |
| 92015 |
Determination of refractive state |
26 |
26 |
$330.07 |
| 81025 |
|
31 |
28 |
$201.80 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
13 |
13 |
$194.61 |
| 90621 |
|
25 |
24 |
$149.79 |
| J7626 |
Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg |
36 |
36 |
$105.70 |
| 90715 |
|
27 |
25 |
$98.99 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
1,077 |
986 |
$80.27 |
| 90686 |
|
252 |
237 |
$75.82 |
| J7510 |
Prednisolone oral, per 5 mg |
653 |
635 |
$53.07 |
| A0425 |
Ground mileage, per statute mile |
13 |
13 |
$46.88 |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
162 |
151 |
$19.36 |
| 90461 |
|
61 |
60 |
$0.00 |
| 90633 |
|
13 |
13 |
$0.00 |
| 90670 |
|
67 |
64 |
$0.00 |
| 90685 |
|
16 |
15 |
$0.00 |
| 90734 |
|
12 |
12 |
$0.00 |
| 90647 |
|
63 |
60 |
$0.00 |
| 96127 |
|
60 |
57 |
$0.00 |
| 90651 |
|
16 |
16 |
$0.00 |
| 90723 |
|
46 |
44 |
$0.00 |