| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
14,257 |
12,703 |
$803K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
3,021 |
2,903 |
$311K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
3,333 |
3,207 |
$307K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,260 |
2,164 |
$236K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,237 |
2,066 |
$198K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
6,874 |
6,374 |
$110K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
951 |
866 |
$94K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
310 |
262 |
$27K |
| 99383 |
|
193 |
190 |
$20K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
3,441 |
3,300 |
$11K |
| H0049 |
Alcohol and/or drug screening |
1,005 |
950 |
$9K |
| 99384 |
|
47 |
44 |
$5K |
| 90651 |
|
1,128 |
1,086 |
$4K |
| 90619 |
|
390 |
369 |
$4K |
| 90677 |
|
25 |
25 |
$4K |
| 90670 |
|
618 |
587 |
$3K |
| 90716 |
|
475 |
455 |
$3K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
74 |
74 |
$3K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
60 |
58 |
$2K |
| 99382 |
|
17 |
17 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
487 |
247 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
617 |
573 |
$1K |
| 90620 |
|
723 |
671 |
$888.33 |
| 99381 |
|
12 |
12 |
$819.16 |
| 0072A |
|
16 |
12 |
$424.84 |
| 0071A |
|
14 |
13 |
$390.50 |
| 0011A |
|
16 |
12 |
$275.88 |
| 90700 |
|
1,466 |
1,389 |
$262.67 |
| 90686 |
|
1,281 |
1,201 |
$215.41 |
| 90633 |
|
423 |
406 |
$180.00 |
| 90707 |
|
440 |
413 |
$152.42 |
| 90713 |
|
1,133 |
1,068 |
$143.62 |
| 81002 |
|
1,389 |
1,259 |
$136.73 |
| 90680 |
|
135 |
128 |
$125.00 |
| 90648 |
|
806 |
760 |
$105.56 |
| 94010 |
|
128 |
118 |
$87.22 |
| 94664 |
|
44 |
41 |
$64.62 |
| 91301 |
|
38 |
30 |
$38.88 |
| 90744 |
|
185 |
174 |
$23.53 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
48 |
43 |
$16.21 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
16 |
14 |
$15.68 |
| 36416 |
|
15 |
13 |
$3.00 |
| 91307 |
|
60 |
28 |
$0.00 |
| 90715 |
|
337 |
327 |
$0.00 |
| 90734 |
|
471 |
441 |
$0.00 |
| 96160 |
|
78 |
76 |
$0.00 |
| 2014F |
|
12 |
12 |
$0.00 |