| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,306 |
4,962 |
$404K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,213 |
2,999 |
$374K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
517 |
486 |
$200K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
470 |
422 |
$42K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
439 |
375 |
$39K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,227 |
1,970 |
$38K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,820 |
1,492 |
$27K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
130 |
112 |
$14K |
| 99215 |
Prolong outpt/office vis |
138 |
95 |
$14K |
| 94760 |
|
6,799 |
5,400 |
$13K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
143 |
117 |
$10K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
463 |
432 |
$9K |
| 92587 |
|
545 |
475 |
$8K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
158 |
122 |
$5K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
458 |
409 |
$4K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
249 |
90 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
230 |
161 |
$2K |
| 99177 |
|
217 |
199 |
$2K |
| 90686 |
|
389 |
312 |
$2K |
| 96127 |
|
116 |
74 |
$1K |
| 99000 |
|
541 |
370 |
$1K |
| 94010 |
|
36 |
25 |
$978.37 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
25 |
12 |
$947.50 |
| 87807 |
|
76 |
59 |
$802.31 |
| 99173 |
|
89 |
84 |
$439.17 |
| H0049 |
Alcohol and/or drug screening |
36 |
33 |
$389.21 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
38 |
28 |
$371.90 |
| 90716 |
|
13 |
12 |
$292.54 |
| 90715 |
|
16 |
12 |
$238.05 |
| 90707 |
|
12 |
12 |
$169.30 |
| 94761 |
|
38 |
29 |
$126.67 |
| 99174 |
|
21 |
13 |
$51.33 |
| A7004 |
Small volume nonfiltered pneumatic nebulizer, disposable |
38 |
29 |
$46.50 |
| 81002 |
|
20 |
15 |
$33.40 |
| 90633 |
|
12 |
12 |
$0.00 |
| 90656 |
|
28 |
28 |
$0.00 |