| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
15,865 |
13,359 |
$1.05M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
10,396 |
8,686 |
$455K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,294 |
2,107 |
$144K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,814 |
1,739 |
$116K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,981 |
1,853 |
$115K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
4,154 |
3,786 |
$105K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,255 |
1,199 |
$89K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
5,873 |
5,439 |
$78K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
3,428 |
3,216 |
$48K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
3,234 |
2,949 |
$38K |
| 99381 |
|
508 |
482 |
$35K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,084 |
1,011 |
$24K |
| 99188 |
|
1,143 |
764 |
$17K |
| 92551 |
|
2,197 |
2,094 |
$16K |
| 99051 |
|
1,148 |
1,078 |
$16K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
183 |
158 |
$12K |
| 17110 |
|
189 |
165 |
$12K |
| 90474 |
|
1,205 |
1,136 |
$10K |
| 83655 |
|
853 |
781 |
$9K |
| 99383 |
|
85 |
79 |
$6K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
59 |
57 |
$6K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
127 |
121 |
$4K |
| 99499 |
|
496 |
395 |
$4K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
528 |
475 |
$4K |
| 87807 |
|
298 |
276 |
$4K |
| 99177 |
|
3,070 |
2,643 |
$4K |
| 99382 |
|
42 |
36 |
$3K |
| 99215 |
Prolong outpt/office vis |
29 |
27 |
$3K |
| 99384 |
|
25 |
24 |
$2K |
| 85018 |
|
867 |
809 |
$2K |
| 81025 |
|
262 |
241 |
$1K |
| 81003 |
|
738 |
664 |
$1K |
| 99050 |
|
82 |
75 |
$972.24 |
| 69210 |
|
40 |
24 |
$819.00 |
| 90473 |
|
99 |
96 |
$803.11 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
70 |
64 |
$747.40 |
| 17250 |
|
12 |
12 |
$572.77 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
127 |
79 |
$320.00 |
| 96160 |
|
65 |
58 |
$247.13 |
| 99173 |
|
123 |
117 |
$196.00 |
| 94760 |
|
1,159 |
940 |
$111.33 |
| 90734 |
|
615 |
567 |
$90.68 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
28 |
19 |
$56.82 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
72 |
52 |
$50.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
31 |
16 |
$47.98 |
| 90647 |
|
276 |
250 |
$32.58 |
| 90715 |
|
392 |
361 |
$30.95 |
| 36416 |
|
1,640 |
1,402 |
$20.24 |
| 96127 |
|
24 |
20 |
$18.75 |
| 90688 |
|
43 |
28 |
$17.84 |
| 90680 |
|
1,210 |
1,113 |
$0.00 |
| 3074F |
|
377 |
257 |
$0.00 |
| 90744 |
|
912 |
842 |
$0.00 |
| 90696 |
|
319 |
278 |
$0.00 |
| 90716 |
|
250 |
215 |
$0.00 |
| 90651 |
|
697 |
632 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
552 |
477 |
$0.00 |
| 90698 |
|
1,288 |
1,200 |
$0.00 |
| 90686 |
|
1,473 |
1,353 |
$0.00 |
| G8422 |
Bmi not documented, documentation the patient is not eligible for bmi calculation |
6,579 |
5,324 |
$0.00 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
49 |
39 |
$0.00 |
| 90620 |
|
84 |
74 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
28 |
12 |
$0.00 |
| 3008F |
|
14 |
12 |
$0.00 |
| 90723 |
|
12 |
12 |
$0.00 |
| 90621 |
|
54 |
43 |
$0.00 |
| 90633 |
|
1,169 |
1,024 |
$0.00 |
| 90670 |
|
1,763 |
1,607 |
$0.00 |
| 90710 |
|
548 |
490 |
$0.00 |
| 3078F |
|
209 |
140 |
$0.00 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
109 |
93 |
$0.00 |
| G8421 |
Bmi not documented and no reason is given |
90 |
80 |
$0.00 |
| 90700 |
|
301 |
265 |
$0.00 |
| 90685 |
|
464 |
433 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
148 |
86 |
$0.00 |
| 80061 |
Lipid panel |
72 |
59 |
$0.00 |
| 90707 |
|
162 |
143 |
$0.00 |
| 90672 |
|
103 |
100 |
$0.00 |