| Code | Description | Claims | Beneficiaries | Total Paid |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
14,113 |
12,143 |
$462K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,861 |
1,794 |
$100K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,642 |
1,608 |
$88K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,287 |
1,198 |
$81K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
688 |
645 |
$33K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
3,303 |
3,049 |
$33K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,397 |
1,304 |
$32K |
| 95115 |
|
2,208 |
1,144 |
$24K |
| 99223 |
Prolong inpt eval add15 m |
185 |
170 |
$23K |
| 86403 |
|
1,424 |
1,338 |
$19K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
361 |
342 |
$19K |
| 90670 |
|
1,486 |
1,460 |
$14K |
| 90698 |
|
1,408 |
1,383 |
$13K |
| 83655 |
|
721 |
710 |
$12K |
| 90680 |
|
995 |
977 |
$9K |
| 99381 |
|
138 |
127 |
$7K |
| 90686 |
|
540 |
527 |
$5K |
| 90633 |
|
535 |
528 |
$5K |
| 90744 |
|
522 |
511 |
$5K |
| 36410 |
|
208 |
200 |
$4K |
| 90707 |
|
388 |
382 |
$4K |
| 90716 |
|
378 |
370 |
$3K |
| 90685 |
|
358 |
357 |
$3K |
| 54150 |
|
14 |
14 |
$3K |
| 81000 |
|
602 |
557 |
$2K |
| 90734 |
|
239 |
230 |
$2K |
| 87807 |
|
170 |
155 |
$2K |
| 90651 |
|
193 |
187 |
$2K |
| 90688 |
|
187 |
183 |
$2K |
| 99460 |
|
16 |
15 |
$2K |
| 90715 |
|
104 |
102 |
$994.36 |
| 99231 |
Subsequent hospital care, per day, straightforward or low complexity |
12 |
12 |
$621.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
25 |
13 |
$402.56 |
| 90696 |
|
39 |
37 |
$353.72 |
| 90723 |
|
22 |
22 |
$210.32 |
| 90648 |
|
21 |
21 |
$200.76 |
| 96160 |
|
22 |
22 |
$0.00 |
| 97802 |
|
17 |
17 |
$0.00 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
17 |
17 |
$0.00 |