| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,982 |
3,609 |
$356K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,021 |
952 |
$65K |
| S0281 |
Medical home program, comprehensive care coordination and planning, maintenance of plan |
14,863 |
14,855 |
$50K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,099 |
1,088 |
$45K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
270 |
263 |
$20K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
175 |
174 |
$15K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
173 |
172 |
$15K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
152 |
151 |
$14K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
360 |
351 |
$13K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
687 |
647 |
$10K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
367 |
289 |
$8K |
| 94760 |
|
1,653 |
1,511 |
$4K |
| 99188 |
|
124 |
124 |
$4K |
| 99070 |
|
260 |
254 |
$2K |
| 87081 |
|
505 |
475 |
$2K |
| 92567 |
|
198 |
181 |
$2K |
| 99215 |
Prolong outpt/office vis |
12 |
12 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
17 |
17 |
$2K |
| 87807 |
|
65 |
64 |
$904.80 |
| 95115 |
|
111 |
49 |
$868.09 |
| 88738 |
|
124 |
122 |
$714.87 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
25 |
24 |
$512.88 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
28 |
27 |
$387.99 |
| 83655 |
|
27 |
26 |
$385.84 |
| 99050 |
|
14 |
13 |
$338.52 |
| 99051 |
|
13 |
13 |
$314.34 |
| 36416 |
|
76 |
72 |
$264.96 |
| 93000 |
|
14 |
13 |
$253.89 |
| 94664 |
|
52 |
46 |
$205.92 |
| 94761 |
|
26 |
24 |
$125.20 |
| 85027 |
|
12 |
12 |
$97.68 |
| 81003 |
|
12 |
12 |
$28.60 |
| 99173 |
|
568 |
564 |
$0.00 |
| 90670 |
|
144 |
144 |
$0.00 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
27 |
26 |
$0.00 |
| 90633 |
|
12 |
12 |
$0.00 |
| 90715 |
|
12 |
12 |
$0.00 |
| 90685 |
|
46 |
46 |
$0.00 |
| 90461 |
|
20 |
20 |
$0.00 |
| 90734 |
|
30 |
30 |
$0.00 |
| 90723 |
|
40 |
40 |
$0.00 |
| 96127 |
|
66 |
66 |
$0.00 |
| 90686 |
|
325 |
325 |
$0.00 |
| 92551 |
|
263 |
261 |
$0.00 |
| 90647 |
|
41 |
41 |
$0.00 |
| 96161 |
|
30 |
30 |
$0.00 |
| 90680 |
|
70 |
70 |
$0.00 |
| 90651 |
|
52 |
52 |
$0.00 |