| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,053 |
3,254 |
$277K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,584 |
1,473 |
$152K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,558 |
1,540 |
$52K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
502 |
502 |
$44K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
456 |
456 |
$44K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
414 |
414 |
$37K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,934 |
1,922 |
$21K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
640 |
632 |
$13K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
452 |
408 |
$13K |
| 99215 |
Prolong outpt/office vis |
96 |
93 |
$12K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
132 |
128 |
$11K |
| 90461 |
|
126 |
126 |
$7K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
76 |
74 |
$5K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
248 |
247 |
$3K |
| 0071A |
|
36 |
36 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
108 |
107 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
53 |
53 |
$1K |
| 0072A |
|
24 |
24 |
$1K |
| 87430 |
|
79 |
77 |
$1K |
| 96127 |
|
198 |
198 |
$841.35 |
| 90686 |
|
85 |
85 |
$235.45 |
| 85018 |
|
65 |
65 |
$174.20 |
| 90474 |
|
13 |
13 |
$126.23 |
| 94664 |
|
15 |
15 |
$122.19 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
13 |
13 |
$93.75 |
| 99000 |
|
37 |
34 |
$40.70 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
12 |
12 |
$0.48 |
| 81002 |
|
16 |
16 |
$0.00 |
| 90670 |
|
12 |
12 |
$0.00 |
| 90633 |
|
13 |
13 |
$0.00 |