| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
8,169 |
7,604 |
$234K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,425 |
1,384 |
$51K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,337 |
1,333 |
$8K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
78 |
78 |
$6K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
749 |
748 |
$5K |
| 90670 |
|
185 |
180 |
$3K |
| 99383 |
|
173 |
173 |
$2K |
| 90686 |
|
550 |
547 |
$2K |
| 99215 |
Prolong outpt/office vis |
590 |
559 |
$1K |
| 92551 |
|
832 |
832 |
$1K |
| 90715 |
|
67 |
67 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
168 |
163 |
$1K |
| A4267 |
Contraceptive supply, condom, male, each |
199 |
196 |
$1K |
| 99384 |
|
90 |
90 |
$1K |
| 99382 |
|
134 |
134 |
$928.22 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
592 |
577 |
$877.32 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
124 |
122 |
$855.44 |
| 90649 |
|
43 |
43 |
$824.73 |
| J3490 |
Unclassified drugs |
13 |
13 |
$753.51 |
| 90791 |
Psychiatric diagnostic evaluation |
121 |
119 |
$634.00 |
| 99201 |
|
254 |
254 |
$622.45 |
| 99243 |
|
36 |
35 |
$577.95 |
| 11721 |
|
198 |
198 |
$459.20 |
| 90716 |
|
19 |
19 |
$395.04 |
| 90658 |
|
48 |
48 |
$391.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
747 |
637 |
$314.04 |
| 90707 |
|
18 |
18 |
$306.69 |
| 90647 |
|
108 |
108 |
$296.50 |
| 90723 |
|
82 |
82 |
$267.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
30 |
30 |
$253.05 |
| 94010 |
|
103 |
98 |
$194.80 |
| 83655 |
|
117 |
115 |
$136.76 |
| 85018 |
|
599 |
594 |
$135.30 |
| 88142 |
|
113 |
113 |
$122.40 |
| 90681 |
|
12 |
12 |
$121.79 |
| 90633 |
|
104 |
102 |
$117.36 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
36 |
35 |
$115.92 |
| 99381 |
|
12 |
12 |
$89.76 |
| 93000 |
|
43 |
43 |
$85.23 |
| 11056 |
|
49 |
45 |
$75.21 |
| 82947 |
|
906 |
860 |
$68.04 |
| 90700 |
|
47 |
47 |
$61.26 |
| G0467 |
Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit |
14 |
14 |
$52.23 |
| 81002 |
|
247 |
242 |
$51.12 |
| 81025 |
|
81 |
79 |
$41.55 |
| 86580 |
|
15 |
12 |
$23.50 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
942 |
925 |
$22.42 |
| 82270 |
|
81 |
81 |
$20.23 |
| 99173 |
|
769 |
768 |
$17.26 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
56 |
56 |
$14.04 |
| 99000 |
|
23 |
23 |
$7.18 |
| 36415 |
Collection of venous blood by venipuncture |
23 |
23 |
$4.20 |
| 80305 |
|
12 |
12 |
$2.00 |
| 3008F |
|
1,865 |
1,775 |
$0.00 |
| 1125F |
|
1,476 |
1,425 |
$0.00 |
| 3014F |
|
116 |
110 |
$0.00 |
| 1126F |
|
2,206 |
2,111 |
$0.00 |
| 3074F |
|
2,502 |
2,377 |
$0.00 |
| 3079F |
|
926 |
904 |
$0.00 |
| 3075F |
|
509 |
500 |
$0.00 |
| 99429 |
|
122 |
121 |
$0.00 |
| 1036F |
|
2,123 |
2,026 |
$0.00 |
| 3080F |
|
345 |
342 |
$0.00 |
| 82962 |
|
94 |
92 |
$0.00 |
| 1034F |
|
142 |
136 |
$0.00 |
| 3017F |
|
49 |
47 |
$0.00 |
| 1111F |
|
25 |
24 |
$0.00 |
| 1159F |
|
1,270 |
1,226 |
$0.00 |
| 1160F |
|
954 |
913 |
$0.00 |
| 3078F |
|
2,205 |
2,108 |
$0.00 |
| 3046F |
|
50 |
44 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
144 |
137 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
17 |
17 |
$0.00 |
| 3077F |
|
529 |
514 |
$0.00 |
| 3725F |
|
287 |
284 |
$0.00 |
| 82948 |
|
50 |
50 |
$0.00 |
| 90734 |
|
27 |
27 |
$0.00 |
| 3015F |
|
95 |
92 |
$0.00 |
| 2028F |
|
17 |
17 |
$0.00 |