| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
6,063 |
4,557 |
$446K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,021 |
1,373 |
$78K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
350 |
272 |
$25K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
260 |
225 |
$21K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,218 |
986 |
$18K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,307 |
1,036 |
$15K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
643 |
508 |
$14K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
183 |
127 |
$10K |
| 99199 |
Unlisted special service, procedure or report |
1,525 |
1,370 |
$8K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
598 |
488 |
$7K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
653 |
514 |
$4K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
57 |
50 |
$4K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
215 |
167 |
$2K |
| 81002 |
|
203 |
138 |
$388.57 |
| 90474 |
|
15 |
12 |
$245.40 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
14 |
13 |
$204.50 |
| 92552 |
|
501 |
432 |
$162.50 |
| 90633 |
|
92 |
76 |
$89.31 |
| 90686 |
|
86 |
83 |
$17.74 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
119 |
87 |
$3.68 |
| 99173 |
|
567 |
491 |
$1.00 |
| 90685 |
|
14 |
14 |
$0.00 |
| 90670 |
|
125 |
115 |
$0.00 |
| 90710 |
|
24 |
15 |
$0.00 |
| 90649 |
|
16 |
14 |
$0.00 |
| 90734 |
|
15 |
14 |
$0.00 |
| 90698 |
|
205 |
186 |
$0.00 |
| 90744 |
|
16 |
16 |
$0.00 |
| 90688 |
|
93 |
88 |
$0.00 |