| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,675 |
5,162 |
$372K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,233 |
3,067 |
$108K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,570 |
1,475 |
$71K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,006 |
949 |
$68K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
925 |
896 |
$66K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
518 |
498 |
$35K |
| 95165 |
Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials |
115 |
12 |
$25K |
| 90461 |
|
1,164 |
1,075 |
$21K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,095 |
1,037 |
$19K |
| 95117 |
|
967 |
363 |
$8K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
90 |
89 |
$7K |
| 92551 |
|
1,170 |
1,113 |
$7K |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
15 |
15 |
$6K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
276 |
258 |
$4K |
| 99381 |
|
13 |
12 |
$957.28 |
| 99173 |
|
560 |
543 |
$759.39 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
19 |
12 |
$434.71 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
13 |
13 |
$391.03 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
14 |
14 |
$303.60 |
| 99177 |
|
14 |
13 |
$182.92 |
| 90686 |
|
383 |
370 |
$36.34 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
13 |
12 |
$10.93 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
12 |
12 |
$1.65 |
| 90700 |
|
360 |
328 |
$0.00 |
| 90670 |
|
504 |
457 |
$0.00 |
| 90713 |
|
170 |
152 |
$0.00 |
| 90633 |
|
29 |
27 |
$0.00 |
| 90685 |
|
46 |
45 |
$0.00 |
| 90734 |
|
12 |
12 |
$0.00 |
| 90647 |
|
272 |
242 |
$0.00 |
| 90680 |
|
243 |
222 |
$0.00 |
| 90744 |
|
18 |
13 |
$0.00 |