| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,455 |
1,296 |
$85K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,035 |
1,706 |
$80K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
513 |
502 |
$30K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
469 |
455 |
$25K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,323 |
541 |
$13K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
653 |
636 |
$13K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
863 |
845 |
$12K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
178 |
170 |
$9K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
348 |
301 |
$4K |
| 87807 |
|
402 |
290 |
$4K |
| 92551 |
|
390 |
379 |
$3K |
| 90473 |
|
237 |
234 |
$2K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
240 |
218 |
$2K |
| 99215 |
Prolong outpt/office vis |
17 |
17 |
$2K |
| 83655 |
|
115 |
108 |
$1K |
| 99177 |
|
495 |
440 |
$697.81 |
| 96127 |
|
309 |
297 |
$536.25 |
| 96161 |
|
405 |
386 |
$460.00 |
| 85018 |
|
155 |
141 |
$320.06 |
| 99173 |
|
210 |
202 |
$249.74 |
| 81003 |
|
37 |
28 |
$52.88 |
| 96160 |
|
37 |
36 |
$33.75 |
| 90686 |
|
400 |
391 |
$19.03 |
| 90633 |
|
128 |
127 |
$0.01 |
| 90670 |
|
392 |
381 |
$0.00 |
| 90648 |
|
260 |
253 |
$0.00 |
| 90685 |
|
111 |
106 |
$0.00 |
| 90710 |
|
71 |
70 |
$0.00 |
| J7510 |
Prednisolone oral, per 5 mg |
40 |
37 |
$0.00 |
| J7610 |
Albuterol, inhalation solution, compounded product, administered through dme, concentrated form, 1 mg |
246 |
211 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
881 |
798 |
$0.00 |
| 90680 |
|
243 |
238 |
$0.00 |
| 90723 |
|
115 |
113 |
$0.00 |
| 90698 |
|
12 |
12 |
$0.00 |