| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,519 |
1,390 |
$56K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
115 |
115 |
$11K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
55 |
55 |
$5K |
| 99231 |
Subsequent hospital care, per day, straightforward or low complexity |
148 |
39 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
35 |
35 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
233 |
227 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
38 |
38 |
$2K |
| 92552 |
|
406 |
405 |
$1K |
| 99173 |
|
228 |
227 |
$603.30 |
| 99188 |
|
29 |
29 |
$522.00 |
| 99222 |
Initial hospital care, per day, moderate complexity |
13 |
13 |
$415.95 |
| A4245 |
Alcohol wipes, per box |
310 |
304 |
$236.00 |
| 99238 |
Hospital discharge day management, 30 minutes or less |
13 |
13 |
$205.70 |
| G0008 |
Administration of influenza virus vaccine |
27 |
27 |
$176.00 |
| A4209 |
Syringe with needle, sterile 5 cc or greater, each |
337 |
331 |
$160.64 |
| 90648 |
|
12 |
12 |
$132.00 |
| 92551 |
|
63 |
62 |
$114.40 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
24 |
13 |
$92.28 |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
12 |
12 |
$90.75 |
| 96127 |
|
81 |
81 |
$88.00 |
| 96160 |
|
64 |
62 |
$42.13 |
| 3074F |
|
1,184 |
1,100 |
$0.00 |
| 3079F |
|
45 |
45 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
39 |
39 |
$0.00 |
| 99174 |
|
32 |
31 |
$0.00 |
| 85018 |
|
12 |
12 |
$0.00 |
| 86701 |
|
13 |
13 |
$0.00 |
| 3078F |
|
1,015 |
949 |
$0.00 |
| 83655 |
|
174 |
170 |
$0.00 |
| 80061 |
Lipid panel |
31 |
31 |
$0.00 |
| A6413 |
Adhesive bandage, first-aid type, any size, each |
12 |
12 |
$0.00 |