| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
5,913 |
4,969 |
$142K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
4,967 |
4,568 |
$103K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
1,039 |
1,032 |
$44K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
1,039 |
1,032 |
$44K |
| 97139 |
|
1,910 |
313 |
$43K |
| 97799 |
|
954 |
189 |
$21K |
| 90716 |
|
1,028 |
1,022 |
$18K |
| 83655 |
|
566 |
566 |
$14K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,260 |
3,008 |
$13K |
| 90707 |
|
640 |
640 |
$9K |
| 90715 |
|
816 |
813 |
$9K |
| 97750 |
|
177 |
93 |
$8K |
| 97161 |
|
114 |
59 |
$4K |
| 86703 |
|
248 |
247 |
$4K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
70 |
70 |
$4K |
| 90714 |
|
170 |
170 |
$3K |
| 87177 |
|
260 |
157 |
$3K |
| 90651 |
|
242 |
242 |
$3K |
| 90734 |
|
174 |
174 |
$3K |
| 90633 |
|
459 |
459 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
63 |
28 |
$2K |
| 92552 |
|
122 |
39 |
$2K |
| 90686 |
|
498 |
456 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
41 |
13 |
$2K |
| 88313 |
|
33 |
17 |
$2K |
| J3490 |
Unclassified drugs |
37 |
37 |
$2K |
| 90713 |
|
214 |
214 |
$1K |
| 86592 |
|
247 |
246 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
28 |
28 |
$971.32 |
| 90696 |
|
72 |
72 |
$950.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,346 |
1,286 |
$924.91 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
15 |
15 |
$899.68 |
| 90744 |
|
107 |
107 |
$775.00 |
| 87209 |
|
34 |
28 |
$743.58 |
| 85018 |
|
321 |
134 |
$664.47 |
| 90670 |
|
141 |
92 |
$495.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
24 |
24 |
$450.00 |
| D1206 |
Topical application of fluoride varnish |
17 |
17 |
$408.00 |
| 99173 |
|
103 |
34 |
$374.16 |
| 90688 |
|
14 |
14 |
$273.00 |
| 81003 |
|
40 |
38 |
$78.40 |
| 81025 |
|
25 |
25 |
$70.00 |
| 90662 |
|
204 |
204 |
$54.79 |
| 86580 |
|
12 |
12 |
$40.32 |
| 90674 |
|
42 |
42 |
$25.00 |
| 90647 |
|
169 |
148 |
$25.00 |
| 90723 |
|
277 |
256 |
$25.00 |
| 90677 |
|
34 |
34 |
$0.00 |
| 94760 |
|
34 |
31 |
$0.00 |
| 90680 |
|
13 |
13 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
72 |
65 |
$0.00 |
| 90648 |
|
13 |
13 |
$0.00 |
| 90700 |
|
24 |
24 |
$0.00 |