| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,162 |
4,912 |
$292K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,305 |
1,260 |
$105K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,043 |
1,042 |
$77K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
917 |
911 |
$60K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
593 |
593 |
$42K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
478 |
478 |
$39K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,430 |
1,415 |
$28K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
704 |
703 |
$9K |
| 87428 |
|
360 |
357 |
$9K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,197 |
1,193 |
$9K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
530 |
525 |
$7K |
| 99000 |
|
727 |
702 |
$7K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
194 |
192 |
$5K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
369 |
337 |
$4K |
| 96127 |
|
1,109 |
1,026 |
$3K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
77 |
76 |
$2K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
118 |
113 |
$2K |
| 99051 |
|
250 |
245 |
$1K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
127 |
126 |
$817.48 |
| 99177 |
|
485 |
485 |
$729.14 |
| 83655 |
|
58 |
58 |
$594.65 |
| 90473 |
|
69 |
68 |
$203.52 |
| 36416 |
|
103 |
102 |
$95.00 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
14 |
14 |
$91.31 |
| 2000F |
|
657 |
628 |
$5.22 |
| 3008F |
|
252 |
250 |
$0.69 |
| 90686 |
|
959 |
959 |
$0.12 |
| G9002 |
Coordinated care fee, maintenance rate |
16 |
14 |
$0.07 |
| 3078F |
|
672 |
642 |
$0.03 |
| 3074F |
|
666 |
636 |
$0.03 |
| 90670 |
|
627 |
627 |
$0.00 |
| 99072 |
|
239 |
236 |
$0.00 |
| G9920 |
Screening performed and negative |
42 |
42 |
$0.00 |
| 90633 |
|
142 |
142 |
$0.00 |
| 99173 |
|
31 |
31 |
$0.00 |
| 90685 |
|
33 |
33 |
$0.00 |
| 91300 |
|
28 |
26 |
$0.00 |
| 90734 |
|
12 |
12 |
$0.00 |
| 90698 |
|
421 |
421 |
$0.00 |
| Q3014 |
Telehealth originating site facility fee |
44 |
43 |
$0.00 |
| 90680 |
|
236 |
236 |
$0.00 |
| 90697 |
|
81 |
81 |
$0.00 |
| 91307 |
|
28 |
28 |
$0.00 |
| 90651 |
|
50 |
50 |
$0.00 |
| 90744 |
|
25 |
25 |
$0.00 |