| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,413 |
3,022 |
$157K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,170 |
1,075 |
$32K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
474 |
444 |
$32K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
363 |
343 |
$25K |
| 95165 |
Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials |
119 |
12 |
$24K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
299 |
277 |
$21K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
263 |
243 |
$20K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
210 |
202 |
$14K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
691 |
507 |
$7K |
| 92551 |
|
998 |
907 |
$3K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
47 |
39 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
49 |
31 |
$631.43 |
| 99173 |
|
748 |
670 |
$365.88 |
| S0119 |
Ondansetron, oral, 4 mg (for circumstances falling under the medicare statute, use hcpcs q code) |
13 |
13 |
$260.00 |
| 90461 |
|
15 |
13 |
$142.34 |
| 99000 |
|
183 |
123 |
$107.15 |
| 96160 |
|
42 |
38 |
$76.78 |
| 99051 |
|
15 |
14 |
$8.89 |
| 90686 |
|
293 |
235 |
$0.00 |
| 90698 |
|
17 |
15 |
$0.00 |
| 90734 |
|
17 |
13 |
$0.00 |
| 90633 |
|
12 |
12 |
$0.00 |
| 90670 |
|
79 |
71 |
$0.00 |