| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,570 |
2,933 |
$396K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,613 |
3,043 |
$281K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,327 |
2,116 |
$72K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
456 |
399 |
$21K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
195 |
175 |
$20K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
158 |
153 |
$16K |
| 90461 |
|
364 |
343 |
$15K |
| G9001 |
Coordinated care fee, initial rate |
186 |
186 |
$7K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
446 |
198 |
$7K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
430 |
398 |
$7K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
39 |
38 |
$4K |
| 99215 |
Prolong outpt/office vis |
27 |
24 |
$4K |
| 96127 |
|
897 |
641 |
$3K |
| 94760 |
|
2,948 |
2,496 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
28 |
26 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
244 |
219 |
$2K |
| 87807 |
|
92 |
79 |
$1K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
37 |
26 |
$1K |
| 0004A |
|
24 |
19 |
$760.00 |
| 0072A |
|
17 |
17 |
$680.00 |
| 0071A |
|
15 |
15 |
$600.00 |
| 0002A |
|
13 |
13 |
$520.00 |
| 83655 |
|
27 |
26 |
$345.58 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
32 |
27 |
$288.30 |
| 85018 |
|
53 |
51 |
$129.49 |
| 91307 |
|
54 |
46 |
$0.02 |
| 91300 |
|
105 |
82 |
$0.01 |
| 90686 |
|
655 |
576 |
$0.00 |
| 99000 |
|
241 |
218 |
$0.00 |
| 36416 |
|
69 |
67 |
$0.00 |
| 90657 |
|
74 |
72 |
$0.00 |
| J7609 |
Albuterol, inhalation solution, compounded product, administered through dme, unit dose, 1 mg |
30 |
27 |
$0.00 |
| A7016 |
Dome and mouthpiece, used with small volume ultrasonic nebulizer |
30 |
27 |
$0.00 |
| 90698 |
|
12 |
12 |
$0.00 |
| 90672 |
|
51 |
42 |
$0.00 |
| 90734 |
|
27 |
27 |
$0.00 |
| 90658 |
|
143 |
141 |
$0.00 |