| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
7,490 |
7,008 |
$203K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
374 |
354 |
$24K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
204 |
203 |
$14K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
794 |
781 |
$11K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
331 |
326 |
$8K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
250 |
233 |
$5K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
103 |
100 |
$5K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
57 |
57 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
453 |
444 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
23 |
23 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
77 |
67 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
30 |
29 |
$1K |
| 90686 |
|
148 |
145 |
$503.38 |
| 71046 |
Radiologic examination, chest; 2 views |
71 |
69 |
$411.41 |
| J0702 |
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg |
14 |
12 |
$286.42 |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
15 |
15 |
$179.84 |
| 90662 |
|
17 |
17 |
$98.06 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
15 |
15 |
$27.69 |
| J3490 |
Unclassified drugs |
14 |
12 |
$13.86 |
| 90698 |
|
84 |
83 |
$0.01 |
| 90670 |
|
129 |
127 |
$0.00 |
| 90648 |
|
28 |
27 |
$0.00 |
| 90700 |
|
15 |
15 |
$0.00 |
| 90461 |
|
14 |
14 |
$0.00 |
| 90633 |
|
16 |
16 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
30 |
30 |
$0.00 |
| 90744 |
|
13 |
13 |
$0.00 |
| 99000 |
|
16 |
15 |
$0.00 |
| 90680 |
|
12 |
12 |
$0.00 |