| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,278 |
4,516 |
$299K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,480 |
1,326 |
$132K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,645 |
2,636 |
$86K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
712 |
710 |
$54K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
550 |
541 |
$39K |
| 99354 |
|
299 |
263 |
$23K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
265 |
265 |
$21K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
962 |
922 |
$20K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
2,230 |
2,220 |
$11K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
157 |
144 |
$11K |
| 99215 |
Prolong outpt/office vis |
80 |
75 |
$10K |
| 92551 |
|
1,069 |
1,063 |
$8K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
567 |
552 |
$3K |
| 99417 |
Prolong home eval add 15m |
26 |
25 |
$3K |
| H0049 |
Alcohol and/or drug screening |
428 |
428 |
$3K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
584 |
578 |
$3K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
350 |
346 |
$2K |
| G0444 |
Annual depression screening, 5 to 15 minutes |
406 |
406 |
$2K |
| 99406 |
|
290 |
289 |
$1K |
| 96160 |
|
26 |
26 |
$1K |
| 83655 |
|
155 |
155 |
$1K |
| 86580 |
|
220 |
219 |
$1K |
| 81005 |
|
445 |
433 |
$776.67 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
336 |
333 |
$744.76 |
| 86480 |
|
82 |
82 |
$744.12 |
| 0072A |
|
15 |
15 |
$560.00 |
| 80053 |
Comprehensive metabolic panel |
390 |
388 |
$534.92 |
| 0071A |
|
14 |
14 |
$520.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
110 |
106 |
$502.52 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
286 |
286 |
$494.70 |
| 0001A |
|
12 |
12 |
$434.30 |
| 0002A |
|
12 |
12 |
$434.30 |
| 80061 |
Lipid panel |
343 |
341 |
$410.88 |
| 94644 |
|
41 |
39 |
$406.66 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
14 |
13 |
$232.96 |
| 90686 |
|
873 |
873 |
$198.71 |
| 87070 |
|
160 |
157 |
$160.26 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
13 |
13 |
$98.52 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
13 |
13 |
$98.52 |
| 87806 |
|
24 |
24 |
$96.30 |
| 94645 |
|
20 |
13 |
$81.03 |
| 99172 |
|
932 |
926 |
$77.47 |
| 36410 |
|
128 |
127 |
$59.52 |
| 84479 |
|
77 |
77 |
$40.46 |
| 90473 |
|
25 |
25 |
$37.50 |
| 99051 |
|
67 |
55 |
$28.00 |
| 87400 |
|
13 |
12 |
$22.48 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
42 |
39 |
$13.35 |
| 86756 |
|
25 |
25 |
$12.24 |
| 86003 |
|
13 |
13 |
$8.14 |
| 86592 |
|
12 |
12 |
$5.98 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
12 |
12 |
$4.48 |
| J7510 |
Prednisolone oral, per 5 mg |
12 |
12 |
$0.42 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
685 |
685 |
$0.00 |
| 1000F |
|
587 |
587 |
$0.00 |
| G9275 |
Documentation that patient is a current non-tobacco user |
574 |
574 |
$0.00 |
| 1036F |
|
587 |
587 |
$0.00 |
| 90680 |
|
13 |
13 |
$0.00 |
| 91307 |
|
63 |
53 |
$0.00 |
| 90656 |
|
46 |
46 |
$0.00 |
| 90677 |
|
14 |
14 |
$0.00 |
| 96127 |
|
12 |
12 |
$0.00 |
| 90647 |
|
25 |
25 |
$0.00 |
| 99080 |
|
2,254 |
2,021 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
322 |
322 |
$0.00 |
| G9920 |
Screening performed and negative |
143 |
143 |
$0.00 |
| 90658 |
|
74 |
74 |
$0.00 |
| 91300 |
|
46 |
40 |
$0.00 |
| 90670 |
|
62 |
62 |
$0.00 |
| 90661 |
|
66 |
66 |
$0.00 |
| 90633 |
|
14 |
14 |
$0.00 |
| 90734 |
|
12 |
12 |
$0.00 |