| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
8,006 |
7,005 |
$483K |
| S0281 |
Medical home program, comprehensive care coordination and planning, maintenance of plan |
53,851 |
53,401 |
$299K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
5,757 |
5,425 |
$257K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,370 |
2,300 |
$199K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,587 |
2,416 |
$193K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,419 |
1,335 |
$123K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,370 |
1,335 |
$115K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,922 |
1,720 |
$71K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
3,067 |
2,818 |
$67K |
| 87632 |
|
137 |
133 |
$34K |
| D1206 |
Topical application of fluoride varnish |
813 |
759 |
$23K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
162 |
157 |
$16K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
170 |
167 |
$16K |
| 90651 |
|
109 |
98 |
$11K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
196 |
187 |
$10K |
| 90633 |
|
728 |
706 |
$8K |
| 96127 |
|
1,257 |
1,162 |
$6K |
| 94760 |
|
2,104 |
1,954 |
$6K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
123 |
122 |
$5K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
232 |
220 |
$3K |
| 90734 |
|
32 |
24 |
$3K |
| 99381 |
|
31 |
30 |
$3K |
| Q3014 |
Telehealth originating site facility fee |
142 |
139 |
$3K |
| S0280 |
Medical home program, comprehensive care coordination and planning, initial plan |
861 |
860 |
$3K |
| 99000 |
|
330 |
318 |
$2K |
| 99058 |
|
66 |
65 |
$2K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
75 |
74 |
$1K |
| 83655 |
|
88 |
88 |
$1K |
| 90670 |
|
1,860 |
1,704 |
$964.19 |
| 36416 |
|
266 |
251 |
$890.06 |
| 99051 |
|
26 |
26 |
$589.50 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
34 |
34 |
$525.14 |
| 0001A |
|
16 |
15 |
$480.00 |
| 0002A |
|
13 |
13 |
$480.00 |
| 90677 |
|
271 |
258 |
$473.66 |
| 90697 |
|
592 |
488 |
$419.46 |
| 85018 |
|
208 |
199 |
$380.25 |
| 80061 |
Lipid panel |
26 |
21 |
$294.00 |
| 90680 |
|
1,222 |
1,193 |
$237.85 |
| 96161 |
|
72 |
68 |
$99.01 |
| 90698 |
|
326 |
325 |
$87.76 |
| 90686 |
|
1,637 |
1,609 |
$60.41 |
| 90656 |
|
147 |
142 |
$17.28 |
| 90648 |
|
550 |
549 |
$0.04 |
| 90723 |
|
533 |
532 |
$0.03 |
| 99174 |
|
470 |
456 |
$0.00 |
| 90716 |
|
28 |
28 |
$0.00 |
| 90688 |
|
487 |
475 |
$0.00 |
| 90696 |
|
12 |
12 |
$0.00 |
| 90619 |
|
13 |
13 |
$0.00 |
| G2211 |
Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) |
86 |
81 |
$0.00 |
| 90461 |
|
3,385 |
3,145 |
$0.00 |
| 91300 |
|
29 |
28 |
$0.00 |
| 90687 |
|
23 |
23 |
$0.00 |
| 90707 |
|
39 |
39 |
$0.00 |
| 99177 |
|
42 |
41 |
$0.00 |
| 96160 |
|
37 |
36 |
$0.00 |
| 90715 |
|
13 |
13 |
$0.00 |
| 90710 |
|
12 |
12 |
$0.00 |
| 99072 |
|
70 |
68 |
$0.00 |