| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,979 |
1,777 |
$123K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
881 |
706 |
$59K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,126 |
959 |
$52K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
608 |
590 |
$50K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
760 |
661 |
$37K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
515 |
489 |
$25K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,135 |
903 |
$19K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
2,922 |
2,364 |
$15K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
151 |
142 |
$12K |
| 87428 |
|
160 |
153 |
$7K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
102 |
92 |
$6K |
| 99215 |
Prolong outpt/office vis |
72 |
62 |
$6K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
442 |
392 |
$6K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
136 |
118 |
$4K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
28 |
26 |
$3K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
25 |
24 |
$2K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
29 |
29 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
61 |
57 |
$735.29 |
| 0072A |
|
17 |
17 |
$480.00 |
| 0071A |
|
27 |
22 |
$440.00 |
| 90686 |
|
193 |
177 |
$299.70 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
12 |
12 |
$176.40 |
| 86308 |
|
13 |
13 |
$51.16 |
| 96161 |
|
12 |
12 |
$28.75 |
| 91307 |
|
53 |
48 |
$0.00 |
| 90647 |
|
15 |
12 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
13 |
13 |
$0.00 |
| 90723 |
|
15 |
12 |
$0.00 |
| 90461 |
|
271 |
221 |
$0.00 |
| 90670 |
|
67 |
64 |
$0.00 |
| A0425 |
Ground mileage, per statute mile |
85 |
47 |
$0.00 |
| 90648 |
|
14 |
14 |
$0.00 |