| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,118 |
935 |
$39K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,409 |
628 |
$18K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
233 |
212 |
$17K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
277 |
266 |
$15K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
119 |
115 |
$9K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
124 |
116 |
$6K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
57 |
57 |
$5K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
43 |
43 |
$4K |
| 99383 |
|
37 |
34 |
$3K |
| 92587 |
|
282 |
269 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
226 |
214 |
$2K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
86 |
81 |
$2K |
| 99000 |
|
178 |
169 |
$1K |
| 99384 |
|
14 |
14 |
$1K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
55 |
50 |
$537.13 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
36 |
18 |
$336.50 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
14 |
14 |
$317.46 |
| 87400 |
|
42 |
18 |
$312.84 |
| 85018 |
|
186 |
176 |
$247.95 |
| 83655 |
|
26 |
26 |
$204.47 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
15 |
13 |
$121.26 |
| 90461 |
|
445 |
376 |
$78.03 |
| 90677 |
|
200 |
195 |
$35.58 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
17 |
17 |
$18.14 |
| 90697 |
|
12 |
12 |
$0.06 |
| 99173 |
|
285 |
271 |
$0.00 |
| 90681 |
|
46 |
44 |
$0.00 |
| 90633 |
|
83 |
78 |
$0.00 |
| 99051 |
|
143 |
131 |
$0.00 |
| 90658 |
|
18 |
18 |
$0.00 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
16 |
16 |
$0.00 |
| 90734 |
|
20 |
20 |
$0.00 |
| 90715 |
|
13 |
13 |
$0.00 |
| 90710 |
|
17 |
16 |
$0.00 |
| 90651 |
|
29 |
29 |
$0.00 |
| 90696 |
|
14 |
14 |
$0.00 |
| 90656 |
|
122 |
110 |
$0.00 |
| 96161 |
|
33 |
31 |
$0.00 |
| 36416 |
|
109 |
95 |
$0.00 |
| 90381 |
|
14 |
13 |
$0.00 |