| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
21,195 |
19,264 |
$915K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
2,573 |
2,560 |
$214K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
13,352 |
6,463 |
$142K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,820 |
1,798 |
$138K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,763 |
1,755 |
$129K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,919 |
3,721 |
$124K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,347 |
1,334 |
$94K |
| 99000 |
|
5,341 |
5,125 |
$52K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
3,252 |
3,150 |
$44K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
2,577 |
1,271 |
$35K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,980 |
1,955 |
$15K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
263 |
255 |
$14K |
| 90461 |
|
1,811 |
1,546 |
$13K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
163 |
163 |
$13K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,049 |
806 |
$11K |
| 99383 |
|
87 |
87 |
$7K |
| 96160 |
|
3,192 |
3,169 |
$7K |
| 99384 |
|
67 |
67 |
$6K |
| 99381 |
|
99 |
91 |
$6K |
| 99215 |
Prolong outpt/office vis |
80 |
79 |
$6K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
426 |
410 |
$5K |
| 81002 |
|
2,184 |
2,100 |
$5K |
| J0702 |
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg |
183 |
176 |
$4K |
| 97169 |
|
118 |
116 |
$3K |
| 90480 |
|
84 |
83 |
$2K |
| 96161 |
|
874 |
866 |
$2K |
| 86756 |
|
116 |
115 |
$2K |
| 74018 |
|
16 |
15 |
$386.66 |
| 82947 |
|
71 |
68 |
$190.07 |
| 93000 |
|
16 |
16 |
$177.60 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
56 |
53 |
$99.46 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
29 |
27 |
$58.18 |
| 81000 |
|
148 |
141 |
$49.75 |
| 81003 |
|
67 |
64 |
$37.45 |
| 82948 |
|
53 |
49 |
$21.15 |
| 90619 |
|
677 |
670 |
$0.62 |
| 83655 |
|
123 |
123 |
$0.47 |
| 85018 |
|
123 |
123 |
$0.37 |
| 90686 |
|
2,312 |
2,285 |
$0.18 |
| 90661 |
|
261 |
261 |
$0.15 |
| 90620 |
|
899 |
889 |
$0.04 |
| 90670 |
|
752 |
749 |
$0.02 |
| 1220F |
|
4,230 |
4,164 |
$0.00 |
| 1170F |
|
1,465 |
1,412 |
$0.00 |
| 1126F |
|
596 |
581 |
$0.00 |
| 90698 |
|
141 |
141 |
$0.00 |
| 3008F |
|
1,243 |
1,204 |
$0.00 |
| 1036F |
|
1,115 |
1,079 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
384 |
364 |
$0.00 |
| 90696 |
|
78 |
78 |
$0.00 |
| 1157F |
|
13 |
13 |
$0.00 |
| 90680 |
|
677 |
674 |
$0.00 |
| 90651 |
|
842 |
836 |
$0.00 |
| 3074F |
|
830 |
802 |
$0.00 |
| 1111F |
|
70 |
64 |
$0.00 |
| 1125F |
|
237 |
226 |
$0.00 |
| 90697 |
|
642 |
638 |
$0.00 |
| 90716 |
|
163 |
163 |
$0.00 |
| 90744 |
|
58 |
58 |
$0.00 |
| 1000F |
|
43 |
43 |
$0.00 |
| 3079F |
|
40 |
40 |
$0.00 |
| 3080F |
|
12 |
12 |
$0.00 |
| 1090F |
|
1,387 |
1,336 |
$0.00 |
| 3288F |
|
1,315 |
1,273 |
$0.00 |
| 1160F |
|
1,266 |
1,225 |
$0.00 |
| 90633 |
|
703 |
698 |
$0.00 |
| 90707 |
|
146 |
146 |
$0.00 |
| 90734 |
|
529 |
529 |
$0.00 |
| 3016F |
|
68 |
65 |
$0.00 |
| 3078F |
|
735 |
709 |
$0.00 |
| 1158F |
|
1,189 |
1,152 |
$0.00 |
| 1159F |
|
1,238 |
1,198 |
$0.00 |
| 90700 |
|
56 |
56 |
$0.00 |
| 90715 |
|
365 |
363 |
$0.00 |
| 90648 |
|
69 |
69 |
$0.00 |
| 90671 |
|
707 |
703 |
$0.00 |
| 90710 |
|
124 |
124 |
$0.00 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
120 |
114 |
$0.00 |
| 91321 |
|
17 |
17 |
$0.00 |