| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,876 |
3,316 |
$166K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,480 |
1,253 |
$54K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
759 |
678 |
$46K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
755 |
659 |
$45K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
844 |
631 |
$42K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,223 |
1,104 |
$36K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
494 |
407 |
$25K |
| 92587 |
|
985 |
805 |
$22K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
876 |
631 |
$16K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
202 |
177 |
$14K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,431 |
1,073 |
$11K |
| 96127 |
|
1,517 |
1,263 |
$6K |
| 99173 |
|
807 |
679 |
$3K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
153 |
105 |
$2K |
| 99215 |
Prolong outpt/office vis |
31 |
14 |
$2K |
| 90670 |
|
323 |
283 |
$1K |
| 87807 |
|
97 |
77 |
$741.23 |
| 90461 |
|
746 |
615 |
$551.74 |
| 90680 |
|
85 |
69 |
$330.93 |
| 90723 |
|
83 |
63 |
$314.01 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
18 |
13 |
$236.15 |
| 85018 |
|
103 |
98 |
$176.93 |
| 90648 |
|
261 |
208 |
$174.11 |
| 90734 |
|
46 |
38 |
$170.95 |
| 90686 |
|
224 |
207 |
$133.50 |
| 81003 |
|
86 |
81 |
$124.86 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
12 |
12 |
$109.82 |
| 36416 |
|
104 |
99 |
$98.55 |
| 90633 |
|
41 |
36 |
$87.34 |
| J7611 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, 1 mg |
18 |
13 |
$4.45 |
| 90707 |
|
70 |
52 |
$0.00 |
| 90685 |
|
16 |
16 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
118 |
117 |
$0.00 |
| 90716 |
|
25 |
25 |
$0.00 |
| 90688 |
|
16 |
13 |
$0.00 |
| 94761 |
|
18 |
13 |
$0.00 |