| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
14,034 |
11,203 |
$889K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,339 |
4,076 |
$406K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
5,257 |
5,097 |
$223K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,711 |
1,710 |
$157K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,608 |
1,608 |
$148K |
| 92587 |
|
5,729 |
5,701 |
$109K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,066 |
1,065 |
$92K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
849 |
849 |
$86K |
| 99050 |
|
2,482 |
2,289 |
$45K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
2,808 |
2,657 |
$42K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
798 |
798 |
$16K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
389 |
386 |
$11K |
| 99381 |
|
80 |
80 |
$8K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
362 |
361 |
$5K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
51 |
51 |
$5K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
172 |
155 |
$4K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
881 |
821 |
$2K |
| 81025 |
|
174 |
168 |
$1K |
| 90670 |
|
1,212 |
1,212 |
$0.00 |
| 90707 |
|
691 |
691 |
$0.00 |
| 90633 |
|
694 |
694 |
$0.00 |
| 90713 |
|
1,273 |
1,273 |
$0.00 |
| 90715 |
|
113 |
113 |
$0.00 |
| 90700 |
|
1,589 |
1,589 |
$0.00 |
| 96160 |
|
1,694 |
1,692 |
$0.00 |
| 90649 |
|
129 |
129 |
$0.00 |
| 90734 |
|
431 |
431 |
$0.00 |
| 90685 |
|
33 |
33 |
$0.00 |
| 90680 |
|
841 |
841 |
$0.00 |
| 90647 |
|
1,206 |
1,206 |
$0.00 |
| 90716 |
|
692 |
692 |
$0.00 |
| 90686 |
|
317 |
317 |
$0.00 |
| 90744 |
|
604 |
604 |
$0.00 |
| 90651 |
|
293 |
293 |
$0.00 |
| 90656 |
|
583 |
583 |
$0.00 |