| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
7,552 |
5,077 |
$216K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,652 |
1,339 |
$72K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,532 |
1,196 |
$71K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
987 |
856 |
$57K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
6,075 |
2,205 |
$48K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
296 |
276 |
$20K |
| 90461 |
|
4,537 |
1,332 |
$12K |
| 0082A |
|
299 |
296 |
$11K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
661 |
552 |
$6K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
486 |
431 |
$5K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
216 |
104 |
$5K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
121 |
97 |
$5K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
130 |
98 |
$5K |
| 0072A |
|
209 |
171 |
$4K |
| 99460 |
|
76 |
58 |
$4K |
| 0071A |
|
144 |
92 |
$4K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
15 |
15 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
14 |
14 |
$1K |
| 0081A |
|
14 |
14 |
$240.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
263 |
104 |
$231.80 |
| 0002A |
|
31 |
31 |
$158.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
12 |
12 |
$43.98 |
| 91308 |
|
335 |
332 |
$0.01 |
| 90680 |
|
850 |
707 |
$0.00 |
| 90723 |
|
1,016 |
848 |
$0.00 |
| 90686 |
|
849 |
723 |
$0.00 |
| 90696 |
|
18 |
18 |
$0.00 |
| 90647 |
|
302 |
241 |
$0.00 |
| 91307 |
|
397 |
263 |
$0.00 |
| 90716 |
|
89 |
88 |
$0.00 |
| 90633 |
|
394 |
359 |
$0.00 |
| 90648 |
|
758 |
675 |
$0.00 |
| 90707 |
|
95 |
91 |
$0.00 |
| 90670 |
|
1,239 |
1,046 |
$0.00 |
| 90700 |
|
55 |
54 |
$0.00 |
| 90710 |
|
18 |
18 |
$0.00 |
| 90681 |
|
14 |
14 |
$0.00 |