| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
7,239 |
4,848 |
$152K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
581 |
374 |
$26K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
538 |
388 |
$18K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
342 |
274 |
$15K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
252 |
214 |
$12K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
175 |
142 |
$12K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
179 |
142 |
$7K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
782 |
632 |
$7K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
364 |
252 |
$5K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
508 |
422 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
75 |
57 |
$3K |
| 76801 |
|
27 |
25 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
136 |
93 |
$2K |
| 92551 |
|
271 |
231 |
$1K |
| 81025 |
|
308 |
227 |
$1K |
| 59430 |
|
13 |
12 |
$908.04 |
| 95117 |
|
163 |
87 |
$705.65 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
174 |
102 |
$461.43 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
22 |
12 |
$386.25 |
| T1015 |
Clinic visit/encounter, all-inclusive |
2,606 |
1,660 |
$345.00 |
| 99173 |
|
363 |
267 |
$223.19 |
| 85018 |
|
368 |
194 |
$153.44 |
| 90686 |
|
240 |
198 |
$114.18 |
| 81002 |
|
137 |
101 |
$111.67 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
56 |
32 |
$86.63 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
81 |
64 |
$82.50 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
182 |
152 |
$61.75 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
30 |
16 |
$39.39 |
| 95024 |
|
14 |
13 |
$25.97 |
| 3074F |
|
4,451 |
2,969 |
$5.69 |
| 3078F |
|
4,181 |
2,783 |
$5.64 |
| 3079F |
|
444 |
290 |
$0.09 |
| 3077F |
|
50 |
43 |
$0.03 |
| 3075F |
|
100 |
62 |
$0.02 |
| 1111F |
|
2,954 |
2,209 |
$0.00 |
| 3080F |
|
26 |
24 |
$0.00 |
| 3008F |
|
3,998 |
2,921 |
$0.00 |
| 1036F |
|
2,464 |
1,723 |
$0.00 |
| 1034F |
|
577 |
360 |
$0.00 |
| 36416 |
|
137 |
66 |
$0.00 |
| 1126F |
|
1,419 |
918 |
$0.00 |
| 90680 |
|
71 |
53 |
$0.00 |
| 90723 |
|
53 |
39 |
$0.00 |
| 1031F |
|
13 |
12 |
$0.00 |
| 1125F |
|
45 |
39 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
89 |
75 |
$0.00 |
| 90670 |
|
249 |
188 |
$0.00 |
| 3210F |
|
17 |
16 |
$0.00 |
| 3016F |
|
116 |
111 |
$0.00 |
| 90648 |
|
92 |
66 |
$0.00 |
| G8484 |
Influenza immunization was not administered, reason not given |
42 |
31 |
$0.00 |
| 3725F |
|
105 |
104 |
$0.00 |