| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,129 |
1,673 |
$93K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,379 |
1,008 |
$89K |
| 87428 |
|
216 |
182 |
$13K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
743 |
596 |
$12K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
558 |
450 |
$8K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
539 |
400 |
$8K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
102 |
92 |
$8K |
| 90686 |
|
344 |
294 |
$3K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
343 |
200 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
36 |
28 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
32 |
31 |
$3K |
| 87807 |
|
223 |
163 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
22 |
12 |
$2K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
76 |
36 |
$1K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
236 |
154 |
$396.14 |
| 90734 |
|
12 |
12 |
$200.52 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
354 |
205 |
$198.69 |
| J7626 |
Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg |
56 |
24 |
$119.49 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
63 |
29 |
$7.93 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
45 |
33 |
$0.00 |