| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
10,074 |
9,229 |
$604K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,403 |
2,337 |
$208K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,666 |
1,663 |
$152K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
4,774 |
4,761 |
$123K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,265 |
1,265 |
$116K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,107 |
1,105 |
$110K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,142 |
1,122 |
$98K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
7,124 |
7,084 |
$67K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
5,829 |
5,820 |
$61K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
762 |
749 |
$29K |
| 99173 |
|
1,307 |
1,304 |
$28K |
| 90461 |
|
1,938 |
1,936 |
$17K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
683 |
682 |
$12K |
| 94760 |
|
3,574 |
3,359 |
$9K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
604 |
594 |
$7K |
| 92583 |
|
149 |
148 |
$7K |
| 85018 |
|
1,993 |
1,990 |
$5K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
39 |
39 |
$4K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
322 |
319 |
$4K |
| 99051 |
|
214 |
212 |
$4K |
| 92551 |
|
261 |
260 |
$2K |
| 81002 |
|
508 |
484 |
$1K |
| 99050 |
|
47 |
46 |
$678.96 |
| 99000 |
|
3,708 |
3,651 |
$391.00 |
| 84703 |
|
42 |
40 |
$292.83 |
| 90686 |
|
1,735 |
1,735 |
$279.91 |
| 90473 |
|
14 |
14 |
$247.80 |
| 36416 |
|
1,404 |
1,401 |
$24.00 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
13 |
13 |
$0.27 |
| 90620 |
|
187 |
187 |
$0.27 |
| 90651 |
|
341 |
341 |
$0.00 |
| 90723 |
|
48 |
48 |
$0.00 |
| 90680 |
|
194 |
194 |
$0.00 |
| 90698 |
|
69 |
69 |
$0.00 |
| 90696 |
|
29 |
29 |
$0.00 |
| 90716 |
|
12 |
12 |
$0.00 |
| 90670 |
|
569 |
569 |
$0.00 |
| 90734 |
|
276 |
276 |
$0.00 |
| 90633 |
|
521 |
520 |
$0.00 |
| 90710 |
|
37 |
37 |
$0.00 |
| 90648 |
|
37 |
37 |
$0.00 |
| 90707 |
|
13 |
13 |
$0.00 |