| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
18,623 |
10,769 |
$872K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
22,922 |
13,679 |
$799K |
| 99199 |
Unlisted special service, procedure or report |
85,405 |
49,352 |
$527K |
| 99458 |
|
10,419 |
6,438 |
$351K |
| 99457 |
|
10,697 |
6,522 |
$223K |
| 99051 |
|
18,126 |
8,380 |
$221K |
| 99454 |
|
6,957 |
4,188 |
$159K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
662 |
546 |
$61K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
7,606 |
4,196 |
$58K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
1,093 |
577 |
$57K |
| 93000 |
|
4,534 |
3,129 |
$46K |
| 99401 |
|
2,147 |
1,184 |
$37K |
| 93922 |
|
1,903 |
1,170 |
$32K |
| 94010 |
|
1,782 |
1,257 |
$28K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
1,769 |
1,036 |
$27K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,529 |
1,153 |
$23K |
| 95921 |
|
546 |
401 |
$23K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
2,021 |
782 |
$22K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
278 |
244 |
$21K |
| 99384 |
|
188 |
112 |
$18K |
| G0108 |
Diabetes outpatient self-management training services, individual, per 30 minutes |
2,426 |
1,117 |
$17K |
| E0570 |
Nebulizer, with compressor |
173 |
116 |
$17K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
442 |
334 |
$16K |
| 94664 |
|
2,221 |
1,560 |
$14K |
| 99385 |
|
206 |
110 |
$14K |
| 76706 |
|
411 |
262 |
$13K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
180 |
116 |
$11K |
| 95943 |
|
610 |
364 |
$10K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
342 |
227 |
$10K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
226 |
162 |
$9K |
| 76775 |
|
476 |
292 |
$7K |
| 99383 |
|
93 |
46 |
$6K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
531 |
488 |
$6K |
| 99406 |
|
1,058 |
643 |
$6K |
| 95922 |
|
709 |
486 |
$6K |
| 92551 |
|
1,902 |
1,441 |
$6K |
| 80305 |
|
1,075 |
494 |
$5K |
| 93040 |
|
787 |
533 |
$5K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
998 |
659 |
$5K |
| 99386 |
|
56 |
32 |
$5K |
| 99397 |
|
100 |
50 |
$4K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
37 |
36 |
$3K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
5,479 |
2,987 |
$3K |
| 36415 |
Collection of venous blood by venipuncture |
1,381 |
1,078 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
39 |
31 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
31 |
20 |
$2K |
| 99408 |
|
99 |
45 |
$1K |
| 36410 |
|
151 |
111 |
$1K |
| 99215 |
Prolong outpt/office vis |
28 |
13 |
$1K |
| 81025 |
|
201 |
154 |
$1K |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
263 |
171 |
$876.07 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
136 |
98 |
$800.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
172 |
157 |
$800.00 |
| 99453 |
|
311 |
119 |
$792.04 |
| 81002 |
|
336 |
273 |
$624.20 |
| G8539 |
Functional outcome assessment documented as positive using a standardized tool and a care plan based on identified deficiencies is documented within two days of the functional outcome assessment |
2,718 |
1,655 |
$550.00 |
| 20610 |
|
29 |
19 |
$482.96 |
| 90473 |
|
21 |
15 |
$278.15 |
| G0446 |
Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes |
134 |
100 |
$200.00 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
2,599 |
1,459 |
$131.30 |
| 90686 |
|
204 |
169 |
$36.42 |
| 82947 |
|
18 |
12 |
$33.88 |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
30 |
20 |
$29.89 |
| 99173 |
|
1,421 |
1,163 |
$17.54 |
| 90649 |
|
133 |
81 |
$0.36 |
| 90658 |
|
101 |
85 |
$0.00 |
| 90756 |
|
25 |
24 |
$0.00 |
| G8477 |
Most recent blood pressure has a systolic measurement of >= 140 mmhg and/or a diastolic measurement of >= 90 mmhg |
44 |
42 |
$0.00 |
| 3077F |
|
42 |
36 |
$0.00 |
| 90715 |
|
27 |
25 |
$0.00 |
| 99072 |
|
12 |
12 |
$0.00 |
| 90672 |
|
22 |
16 |
$0.00 |
| G8476 |
Most recent blood pressure has a systolic measurement of < 140 mmhg and a diastolic measurement of < 90 mmhg |
27 |
27 |
$0.00 |
| 90620 |
|
202 |
126 |
$0.00 |
| 90674 |
|
84 |
56 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
90 |
80 |
$0.00 |
| 1125F |
|
106 |
93 |
$0.00 |
| 3080F |
|
46 |
40 |
$0.00 |
| 3075F |
|
16 |
12 |
$0.00 |
| 90688 |
|
17 |
13 |
$0.00 |
| 3079F |
|
20 |
15 |
$0.00 |
| Q2035 |
Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (afluria) |
27 |
27 |
$0.00 |