| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,014 |
2,766 |
$162K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,313 |
3,665 |
$153K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,776 |
1,752 |
$48K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
663 |
655 |
$36K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
559 |
551 |
$29K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
424 |
411 |
$20K |
| 99215 |
Prolong outpt/office vis |
223 |
210 |
$18K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,240 |
1,195 |
$17K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
897 |
888 |
$16K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
204 |
202 |
$12K |
| 92567 |
|
818 |
782 |
$11K |
| 81002 |
|
1,671 |
1,615 |
$6K |
| 92587 |
|
99 |
97 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
244 |
111 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
72 |
61 |
$961.71 |
| 90670 |
|
395 |
386 |
$938.25 |
| 90633 |
|
148 |
147 |
$929.00 |
| 90658 |
|
454 |
438 |
$926.79 |
| 92015 |
Determination of refractive state |
47 |
47 |
$911.95 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
32 |
28 |
$818.90 |
| 90734 |
|
79 |
79 |
$545.50 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
20 |
20 |
$442.28 |
| 94760 |
|
504 |
458 |
$264.00 |
| 90698 |
|
158 |
151 |
$251.75 |
| 90648 |
|
193 |
190 |
$196.25 |
| 90715 |
|
14 |
14 |
$189.00 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
16 |
16 |
$181.26 |
| 90651 |
|
15 |
15 |
$173.25 |
| 90655 |
|
75 |
74 |
$160.50 |
| 90744 |
|
62 |
62 |
$159.25 |
| 90681 |
|
69 |
68 |
$117.25 |
| 90716 |
|
95 |
93 |
$98.25 |
| 90707 |
|
112 |
111 |
$75.25 |
| 90723 |
|
91 |
90 |
$75.25 |
| 97802 |
|
98 |
98 |
$0.00 |
| 90696 |
|
12 |
12 |
$0.00 |