| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,850 |
5,328 |
$331K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,740 |
1,545 |
$132K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,196 |
1,010 |
$30K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,968 |
1,856 |
$28K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
110 |
108 |
$9K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
89 |
85 |
$7K |
| 81003 |
|
1,367 |
1,265 |
$3K |
| 36415 |
Collection of venous blood by venipuncture |
1,291 |
1,169 |
$3K |
| 90686 |
|
271 |
261 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
30 |
29 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
63 |
61 |
$2K |
| 87807 |
|
120 |
111 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
18 |
18 |
$2K |
| 90670 |
|
13 |
13 |
$703.01 |
| 90651 |
|
20 |
20 |
$665.66 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
41 |
39 |
$659.18 |
| 99174 |
|
209 |
201 |
$597.72 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
180 |
178 |
$590.36 |
| 96127 |
|
107 |
91 |
$537.51 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
55 |
54 |
$457.49 |
| 90647 |
|
27 |
26 |
$320.09 |
| 99177 |
|
85 |
84 |
$315.39 |
| 99173 |
|
116 |
113 |
$287.49 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
105 |
104 |
$282.03 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
13 |
12 |
$231.66 |
| 90715 |
|
15 |
15 |
$229.50 |
| 99000 |
|
1,522 |
1,407 |
$159.85 |
| 85018 |
|
54 |
54 |
$149.04 |
| 94760 |
|
706 |
651 |
$44.78 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
14 |
14 |
$10.30 |
| 90461 |
|
17 |
16 |
$0.00 |
| 1101F |
|
103 |
82 |
$0.00 |