| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
5,848 |
5,780 |
$174K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
8,095 |
7,536 |
$34K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
437 |
437 |
$29K |
| Q3014 |
Telehealth originating site facility fee |
831 |
810 |
$22K |
| 99188 |
|
716 |
715 |
$15K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,257 |
1,251 |
$12K |
| 99173 |
|
1,328 |
1,326 |
$5K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,795 |
1,785 |
$5K |
| 99460 |
|
78 |
77 |
$4K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,430 |
1,428 |
$4K |
| 69210 |
|
121 |
120 |
$4K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
567 |
566 |
$4K |
| 99239 |
Hospital discharge day management, more than 30 minutes |
59 |
57 |
$4K |
| 81003 |
|
1,027 |
1,024 |
$2K |
| 99381 |
|
31 |
29 |
$2K |
| 90651 |
|
366 |
366 |
$1K |
| 90686 |
|
1,453 |
1,452 |
$978.10 |
| 90677 |
|
136 |
128 |
$750.00 |
| 90710 |
|
488 |
484 |
$613.66 |
| 90670 |
|
1,302 |
1,298 |
$544.92 |
| 99462 |
|
18 |
12 |
$529.22 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
25 |
25 |
$317.14 |
| 92552 |
|
1,236 |
1,235 |
$286.83 |
| 90698 |
|
720 |
719 |
$283.35 |
| 90620 |
|
12 |
12 |
$259.94 |
| 81002 |
|
92 |
92 |
$211.94 |
| 90734 |
|
260 |
259 |
$200.68 |
| 90680 |
|
540 |
537 |
$108.54 |
| 90744 |
|
291 |
289 |
$108.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
13 |
13 |
$100.68 |
| 90696 |
|
51 |
51 |
$68.06 |
| 90715 |
|
55 |
55 |
$53.31 |
| 90648 |
|
208 |
208 |
$36.54 |
| 90700 |
|
182 |
182 |
$9.00 |
| 90713 |
|
43 |
43 |
$0.00 |
| 90633 |
|
527 |
526 |
$0.00 |
| 90685 |
|
13 |
13 |
$0.00 |
| 3078F |
|
14 |
14 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
18 |
18 |
$0.00 |
| 90707 |
|
27 |
27 |
$0.00 |
| 90716 |
|
27 |
27 |
$0.00 |
| 3074F |
|
14 |
14 |
$0.00 |
| 90656 |
|
63 |
63 |
$0.00 |
| 99383 |
|
12 |
12 |
$0.00 |