| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
8,403 |
6,219 |
$328K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,124 |
1,952 |
$106K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,764 |
1,493 |
$104K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,033 |
963 |
$69K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
3,449 |
3,069 |
$66K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
3,406 |
2,769 |
$28K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
349 |
315 |
$23K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
141 |
134 |
$11K |
| 99460 |
|
168 |
150 |
$9K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
914 |
392 |
$9K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
159 |
137 |
$8K |
| 54150 |
|
13 |
13 |
$3K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
355 |
268 |
$2K |
| 92551 |
|
289 |
274 |
$2K |
| 99381 |
|
30 |
30 |
$2K |
| 99173 |
|
428 |
400 |
$2K |
| 36415 |
Collection of venous blood by venipuncture |
705 |
578 |
$1K |
| 99462 |
|
42 |
32 |
$967.72 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
425 |
346 |
$768.88 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
63 |
63 |
$740.40 |
| 90651 |
|
44 |
44 |
$590.00 |
| 90688 |
|
96 |
93 |
$408.04 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
134 |
131 |
$356.64 |
| 90670 |
|
1,114 |
1,027 |
$354.83 |
| 90716 |
|
258 |
235 |
$352.90 |
| 96160 |
|
83 |
78 |
$214.90 |
| 90700 |
|
235 |
218 |
$179.90 |
| 90680 |
|
780 |
722 |
$122.45 |
| 90648 |
|
859 |
791 |
$105.71 |
| 90707 |
|
257 |
233 |
$104.37 |
| 90633 |
|
363 |
334 |
$88.42 |
| 90713 |
|
44 |
43 |
$46.71 |
| 90723 |
|
855 |
790 |
$35.48 |
| 81002 |
|
13 |
12 |
$33.89 |
| 90686 |
|
187 |
181 |
$22.25 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
19 |
19 |
$0.26 |
| 90734 |
|
14 |
14 |
$0.00 |
| 90649 |
|
15 |
15 |
$0.00 |
| 99000 |
|
497 |
420 |
$0.00 |