| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,203 |
1,859 |
$91K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
388 |
330 |
$24K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
392 |
364 |
$14K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
75 |
71 |
$6K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
62 |
60 |
$6K |
| 90686 |
|
350 |
285 |
$5K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
393 |
251 |
$4K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
42 |
38 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
130 |
123 |
$2K |
| 90670 |
|
71 |
51 |
$2K |
| 0071A |
|
57 |
55 |
$1K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
16 |
12 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
82 |
73 |
$1K |
| 0001A |
|
54 |
54 |
$1K |
| 0011A |
|
23 |
22 |
$969.22 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
18 |
17 |
$917.01 |
| 0013A |
|
20 |
19 |
$842.80 |
| 90649 |
|
27 |
21 |
$685.07 |
| 0012A |
|
14 |
14 |
$589.96 |
| 0072A |
|
26 |
26 |
$587.36 |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
13 |
13 |
$528.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
88 |
78 |
$511.91 |
| 0002A |
|
16 |
16 |
$481.74 |
| 90633 |
|
33 |
28 |
$377.71 |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
14 |
14 |
$372.82 |
| 81003 |
|
130 |
94 |
$278.05 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
73 |
59 |
$226.56 |
| 90656 |
|
21 |
20 |
$208.45 |
| 90734 |
|
16 |
15 |
$205.94 |
| 85018 |
|
17 |
13 |
$37.12 |
| 81002 |
|
15 |
12 |
$26.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
37 |
36 |
$0.00 |
| 90461 |
|
15 |
15 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
126 |
119 |
$0.00 |