| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,698 |
2,858 |
$109K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,262 |
1,094 |
$49K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
887 |
782 |
$19K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
872 |
777 |
$10K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
1,566 |
1,347 |
$9K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
532 |
439 |
$6K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
478 |
451 |
$4K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
378 |
330 |
$4K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
56 |
51 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
33 |
30 |
$2K |
| 36415 |
Collection of venous blood by venipuncture |
1,464 |
1,249 |
$2K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
121 |
113 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
23 |
21 |
$2K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
124 |
98 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
133 |
127 |
$1K |
| 81003 |
|
833 |
756 |
$1K |
| 92551 |
|
162 |
158 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
14 |
14 |
$878.81 |
| 99173 |
|
125 |
123 |
$816.50 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$748.26 |
| 90674 |
|
22 |
22 |
$360.75 |
| 36416 |
|
173 |
137 |
$305.86 |
| 90756 |
|
23 |
23 |
$232.49 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
35 |
28 |
$49.33 |
| 90686 |
|
83 |
76 |
$36.29 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
32 |
28 |
$17.93 |
| 99000 |
|
27 |
25 |
$0.00 |
| J7610 |
Albuterol, inhalation solution, compounded product, administered through dme, concentrated form, 1 mg |
72 |
60 |
$0.00 |