| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,010 |
4,530 |
$26K |
| 93000 |
|
279 |
276 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
376 |
373 |
$1K |
| 99497 |
|
70 |
68 |
$528.94 |
| G2012 |
Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion |
113 |
103 |
$438.99 |
| 92551 |
|
277 |
277 |
$309.53 |
| 71046 |
Radiologic examination, chest; 2 views |
112 |
110 |
$299.65 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
27 |
26 |
$283.44 |
| 92081 |
|
76 |
75 |
$221.75 |
| 90688 |
|
57 |
57 |
$160.74 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
12 |
12 |
$150.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
99 |
99 |
$136.41 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
15 |
15 |
$131.13 |
| 82947 |
|
668 |
618 |
$128.85 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
102 |
96 |
$81.26 |
| 96127 |
|
282 |
278 |
$65.03 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
108 |
107 |
$63.38 |
| 90686 |
|
59 |
58 |
$60.00 |
| 81003 |
|
494 |
481 |
$40.20 |
| 99000 |
|
241 |
237 |
$34.59 |
| 99173 |
|
133 |
133 |
$17.24 |
| 36415 |
Collection of venous blood by venipuncture |
264 |
258 |
$7.84 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
3,225 |
2,959 |
$1.94 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
288 |
286 |
$0.09 |
| 1160F |
|
2,426 |
2,225 |
$0.00 |
| 1159F |
|
2,497 |
2,296 |
$0.00 |
| 3078F |
|
847 |
780 |
$0.00 |
| 1158F |
|
231 |
231 |
$0.00 |
| 3077F |
|
284 |
264 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
12 |
12 |
$0.00 |
| 3015F |
|
291 |
267 |
$0.00 |
| 3725F |
|
301 |
298 |
$0.00 |
| 4013F |
|
155 |
144 |
$0.00 |
| 81025 |
|
43 |
43 |
$0.00 |
| 98966 |
|
50 |
49 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
270 |
249 |
$0.00 |
| 3008F |
|
4,389 |
4,006 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
34 |
34 |
$0.00 |
| 3074F |
|
595 |
556 |
$0.00 |
| 1170F |
|
740 |
670 |
$0.00 |
| 1036F |
|
1,491 |
1,372 |
$0.00 |
| 3014F |
|
208 |
189 |
$0.00 |
| 3075F |
|
205 |
201 |
$0.00 |
| 1125F |
|
276 |
267 |
$0.00 |
| 4010F |
|
296 |
273 |
$0.00 |
| 3079F |
|
209 |
201 |
$0.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
16 |
13 |
$0.00 |
| 98967 |
|
18 |
18 |
$0.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
24 |
22 |
$0.00 |
| 1126F |
|
150 |
150 |
$0.00 |
| 3080F |
|
12 |
12 |
$0.00 |
| Q3014 |
Telehealth originating site facility fee |
19 |
17 |
$0.00 |
| 1101F |
|
21 |
21 |
$0.00 |