| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
10,065 |
8,425 |
$342K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,284 |
1,177 |
$58K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
507 |
492 |
$32K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
626 |
603 |
$28K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
285 |
277 |
$13K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
631 |
546 |
$7K |
| 90656 |
|
717 |
666 |
$6K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
111 |
108 |
$2K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
242 |
209 |
$2K |
| 96127 |
|
233 |
227 |
$1K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
233 |
211 |
$1K |
| 99173 |
|
573 |
566 |
$1K |
| 0011A |
|
26 |
26 |
$1K |
| 90651 |
|
300 |
291 |
$902.35 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
71 |
70 |
$759.90 |
| 0012A |
|
17 |
17 |
$680.00 |
| 0001A |
|
13 |
13 |
$480.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
85 |
81 |
$479.95 |
| 90734 |
|
84 |
82 |
$336.00 |
| A7016 |
Dome and mouthpiece, used with small volume ultrasonic nebulizer |
221 |
199 |
$322.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
142 |
139 |
$230.58 |
| 92551 |
|
139 |
139 |
$190.08 |
| 90620 |
|
27 |
27 |
$112.00 |
| 90655 |
|
12 |
12 |
$96.00 |
| 90686 |
|
401 |
357 |
$48.00 |
| 81025 |
|
12 |
12 |
$18.72 |
| 90685 |
|
45 |
42 |
$8.00 |
| 80061 |
Lipid panel |
262 |
258 |
$0.02 |
| 87490 |
|
94 |
91 |
$0.01 |
| 91301 |
|
47 |
47 |
$0.00 |
| 85018 |
|
16 |
16 |
$0.00 |
| 87590 |
|
71 |
68 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,400 |
2,164 |
$0.00 |
| 91300 |
|
28 |
28 |
$0.00 |
| 83655 |
|
12 |
12 |
$0.00 |
| 86703 |
|
71 |
68 |
$0.00 |
| 81002 |
|
18 |
17 |
$0.00 |