| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
14,715 |
14,001 |
$941K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,363 |
3,258 |
$298K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
7,448 |
7,417 |
$218K |
| 87428 |
|
2,194 |
2,166 |
$136K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
12,019 |
11,649 |
$122K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,262 |
1,261 |
$108K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
11,076 |
11,030 |
$104K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,157 |
1,157 |
$102K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,017 |
997 |
$85K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
465 |
465 |
$44K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,027 |
2,019 |
$35K |
| 99173 |
|
1,111 |
1,109 |
$23K |
| 90461 |
|
1,308 |
1,308 |
$15K |
| 96127 |
|
876 |
858 |
$9K |
| 99051 |
|
514 |
510 |
$8K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
405 |
400 |
$6K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
178 |
175 |
$5K |
| 90480 |
|
98 |
97 |
$4K |
| 92552 |
|
132 |
132 |
$3K |
| 92583 |
|
54 |
54 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
63 |
42 |
$1K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
85 |
85 |
$939.01 |
| 85018 |
|
385 |
385 |
$806.22 |
| 0072A |
|
12 |
12 |
$550.45 |
| 90686 |
|
1,046 |
1,045 |
$390.57 |
| 90674 |
|
270 |
269 |
$96.84 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
12 |
12 |
$0.18 |
| 90661 |
|
279 |
279 |
$0.02 |
| 90677 |
|
26 |
26 |
$0.01 |
| 99072 |
|
972 |
937 |
$0.00 |
| 91321 |
|
58 |
58 |
$0.00 |
| 90648 |
|
13 |
13 |
$0.00 |
| 90633 |
|
14 |
14 |
$0.00 |
| 90670 |
|
25 |
25 |
$0.00 |
| 36416 |
|
127 |
127 |
$0.00 |
| 90651 |
|
14 |
14 |
$0.00 |
| 91307 |
|
29 |
25 |
$0.00 |