| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,235 |
1,417 |
$55K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
781 |
514 |
$29K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
367 |
271 |
$16K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
288 |
198 |
$13K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
315 |
284 |
$5K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
464 |
391 |
$4K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
92 |
61 |
$4K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
208 |
145 |
$3K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
34 |
30 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
195 |
110 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
22 |
13 |
$992.32 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
307 |
185 |
$778.75 |
| 36415 |
Collection of venous blood by venipuncture |
534 |
349 |
$705.47 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
183 |
136 |
$667.71 |
| 81025 |
|
52 |
33 |
$227.16 |
| 82962 |
|
103 |
61 |
$180.90 |
| 93000 |
|
15 |
13 |
$151.80 |
| 81002 |
|
78 |
44 |
$81.28 |
| 80306 |
|
27 |
13 |
$74.80 |
| 94760 |
|
647 |
416 |
$70.48 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
38 |
35 |
$51.35 |
| 90461 |
|
228 |
135 |
$26.25 |
| 99173 |
|
26 |
14 |
$8.66 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
16 |
16 |
$5.28 |
| 90633 |
|
93 |
51 |
$0.06 |
| 90744 |
|
90 |
74 |
$0.00 |
| 90680 |
|
210 |
150 |
$0.00 |
| 90698 |
|
254 |
182 |
$0.00 |
| 90696 |
|
24 |
12 |
$0.00 |
| V5008 |
Hearing screening |
23 |
13 |
$0.00 |
| 90670 |
|
400 |
269 |
$0.00 |
| 90710 |
|
67 |
33 |
$0.00 |
| T1015 |
Clinic visit/encounter, all-inclusive |
180 |
90 |
$0.00 |
| 90685 |
|
14 |
14 |
$0.00 |
| 90700 |
|
34 |
17 |
$0.00 |
| 90648 |
|
24 |
12 |
$0.00 |