| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
5,830 |
5,322 |
$140K |
| 99401 |
|
1,577 |
1,437 |
$43K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
478 |
448 |
$32K |
| 83655 |
|
1,818 |
1,644 |
$24K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
282 |
268 |
$21K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
320 |
266 |
$19K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
941 |
820 |
$13K |
| 99384 |
|
174 |
150 |
$12K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
780 |
668 |
$12K |
| 99402 |
|
283 |
210 |
$12K |
| 99383 |
|
162 |
143 |
$11K |
| 81025 |
|
2,048 |
1,703 |
$11K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
126 |
102 |
$8K |
| 92551 |
|
754 |
631 |
$6K |
| 85018 |
|
1,085 |
882 |
$3K |
| 90651 |
|
367 |
328 |
$3K |
| 90716 |
|
376 |
308 |
$3K |
| Q3014 |
Telehealth originating site facility fee |
167 |
142 |
$2K |
| 99201 |
|
118 |
93 |
$2K |
| 90707 |
|
390 |
321 |
$2K |
| 36416 |
|
1,112 |
911 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
53 |
44 |
$2K |
| 99309 |
Subsequent nursing facility care, per day, low to moderate complexity |
693 |
667 |
$2K |
| 99177 |
|
277 |
230 |
$2K |
| 99173 |
|
187 |
158 |
$1K |
| 90734 |
|
246 |
228 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
23 |
21 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
186 |
170 |
$1K |
| 90688 |
|
166 |
137 |
$940.00 |
| 90715 |
|
245 |
235 |
$695.68 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
32 |
28 |
$675.34 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
19 |
17 |
$672.34 |
| 90632 |
|
14 |
13 |
$573.27 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
58 |
51 |
$569.73 |
| 94250 |
|
32 |
29 |
$567.16 |
| T2028 |
Specialized supply, not otherwise specified, waiver |
14 |
13 |
$432.25 |
| 90633 |
|
510 |
447 |
$203.22 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
13 |
12 |
$168.35 |
| 36415 |
Collection of venous blood by venipuncture |
49 |
44 |
$144.52 |
| 90696 |
|
169 |
142 |
$120.00 |
| 87210 |
|
29 |
24 |
$118.01 |
| 87400 |
|
13 |
13 |
$89.76 |
| 99071 |
|
14 |
13 |
$50.00 |
| 90698 |
|
217 |
186 |
$0.00 |
| 90744 |
|
54 |
43 |
$0.00 |
| 90686 |
|
3,882 |
3,590 |
$0.00 |
| 90723 |
|
64 |
63 |
$0.00 |
| 90461 |
|
1,308 |
1,170 |
$0.00 |
| 90648 |
|
67 |
62 |
$0.00 |
| 90670 |
|
463 |
409 |
$0.00 |
| 90681 |
|
50 |
50 |
$0.00 |