| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,271 |
4,610 |
$186K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
833 |
783 |
$48K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
591 |
590 |
$28K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
394 |
392 |
$17K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,363 |
1,245 |
$16K |
| 99215 |
Prolong outpt/office vis |
120 |
114 |
$8K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
879 |
831 |
$8K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
161 |
160 |
$7K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
195 |
195 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
237 |
236 |
$3K |
| 94664 |
|
197 |
195 |
$2K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
103 |
103 |
$1K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
12 |
12 |
$494.80 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
167 |
163 |
$362.49 |
| 90686 |
|
14 |
14 |
$216.30 |
| 90461 |
|
15 |
15 |
$160.26 |
| 86403 |
|
54 |
54 |
$96.22 |
| A7016 |
Dome and mouthpiece, used with small volume ultrasonic nebulizer |
409 |
379 |
$45.57 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
409 |
379 |
$12.00 |
| 94002 |
|
12 |
12 |
$0.00 |