| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,545 |
3,290 |
$249K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
522 |
522 |
$55K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,103 |
1,361 |
$48K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
380 |
360 |
$37K |
| 90461 |
|
892 |
408 |
$26K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
186 |
185 |
$19K |
| 99460 |
|
182 |
181 |
$17K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
223 |
220 |
$16K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
130 |
130 |
$14K |
| 87428 |
|
103 |
103 |
$8K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
56 |
55 |
$6K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
399 |
195 |
$6K |
| 99080 |
|
718 |
698 |
$5K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
239 |
235 |
$5K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
385 |
380 |
$5K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
256 |
250 |
$4K |
| 96160 |
|
799 |
758 |
$4K |
| S9999 |
Sales tax |
356 |
312 |
$3K |
| 99072 |
|
210 |
199 |
$3K |
| 0072A |
|
34 |
33 |
$1K |
| 0071A |
|
32 |
30 |
$1K |
| 96127 |
|
91 |
53 |
$1K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
31 |
31 |
$345.07 |
| 90686 |
|
442 |
439 |
$0.00 |
| 91307 |
|
77 |
64 |
$0.00 |
| 90656 |
|
17 |
17 |
$0.00 |
| 90674 |
|
13 |
13 |
$0.00 |
| 90756 |
|
34 |
34 |
$0.00 |
| 90672 |
|
49 |
49 |
$0.00 |