| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,119 |
2,780 |
$287K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,396 |
2,245 |
$269K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,478 |
1,350 |
$172K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
397 |
334 |
$49K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,950 |
1,832 |
$38K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,933 |
851 |
$27K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,261 |
1,191 |
$25K |
| 90670 |
|
896 |
804 |
$11K |
| 36415 |
Collection of venous blood by venipuncture |
2,734 |
2,539 |
$10K |
| 90461 |
|
515 |
293 |
$9K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
68 |
63 |
$8K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
43 |
43 |
$7K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
59 |
45 |
$5K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
30 |
28 |
$1K |
| 90671 |
|
55 |
40 |
$1K |
| 96127 |
|
223 |
199 |
$1K |
| 90723 |
|
82 |
76 |
$561.77 |
| 90474 |
|
39 |
38 |
$556.68 |
| 59025 |
Fetal non-stress test |
13 |
12 |
$513.74 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
20 |
14 |
$509.26 |
| 90648 |
|
277 |
252 |
$427.15 |
| 90697 |
|
75 |
71 |
$400.52 |
| 90677 |
|
13 |
12 |
$251.02 |
| 90686 |
|
45 |
44 |
$143.52 |
| 80053 |
Comprehensive metabolic panel |
43 |
35 |
$42.24 |
| 83718 |
|
14 |
14 |
$40.95 |
| 90633 |
|
15 |
12 |
$31.45 |
| 84478 |
|
14 |
14 |
$28.70 |
| 90700 |
|
14 |
14 |
$24.01 |
| 82465 |
|
14 |
14 |
$21.75 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
41 |
33 |
$19.42 |
| 84443 |
Thyroid stimulating hormone (TSH) |
47 |
34 |
$16.80 |
| 90681 |
|
40 |
38 |
$0.02 |
| 84436 |
|
20 |
16 |
$0.00 |
| 1220F |
|
76 |
71 |
$0.00 |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
44 |
34 |
$0.00 |
| 84479 |
|
20 |
16 |
$0.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
59 |
47 |
$0.00 |
| 86376 |
|
20 |
16 |
$0.00 |
| 0502F |
|
332 |
277 |
$0.00 |
| 90710 |
|
12 |
12 |
$0.00 |
| 83540 |
|
38 |
31 |
$0.00 |
| 83721 |
|
14 |
14 |
$0.00 |