| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,157 |
2,485 |
$181K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
914 |
836 |
$75K |
| 92552 |
|
784 |
723 |
$17K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,142 |
1,093 |
$17K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
163 |
145 |
$12K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
162 |
140 |
$11K |
| 97802 |
|
608 |
549 |
$10K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
424 |
411 |
$8K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
80 |
80 |
$7K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
983 |
897 |
$7K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
462 |
255 |
$5K |
| 93000 |
|
348 |
309 |
$4K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
198 |
198 |
$4K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
658 |
598 |
$4K |
| 86580 |
|
491 |
435 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
29 |
28 |
$2K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
101 |
97 |
$2K |
| 99173 |
|
758 |
696 |
$1K |
| 69210 |
|
34 |
30 |
$1K |
| 97803 |
|
58 |
56 |
$567.97 |
| 90686 |
|
353 |
351 |
$475.75 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
21 |
20 |
$330.60 |
| 96127 |
|
70 |
69 |
$310.67 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
14 |
12 |
$209.93 |
| 96160 |
|
247 |
239 |
$155.88 |
| 90715 |
|
14 |
14 |
$117.60 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
14 |
12 |
$7.23 |