| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
33,002 |
29,088 |
$1.88M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
21,912 |
19,158 |
$1.77M |
| J1568 |
Injection, immune globulin, (octagam), intravenous, non-lyophilized (e.g., liquid), 500 mg |
340 |
232 |
$553K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
4,175 |
3,941 |
$369K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
3,193 |
2,935 |
$276K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,933 |
1,795 |
$185K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
4,497 |
4,207 |
$179K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
9,400 |
8,465 |
$159K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,929 |
1,689 |
$151K |
| 95117 |
|
12,745 |
7,639 |
$143K |
| Q3014 |
Telehealth originating site facility fee |
6,755 |
6,252 |
$141K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
802 |
740 |
$102K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
4,299 |
3,969 |
$84K |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
806 |
752 |
$78K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
2,274 |
1,596 |
$70K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
837 |
682 |
$68K |
| J1569 |
Injection, immune globulin, (gammagard liquid), non-lyophilized, (e.g., liquid), 500 mg |
24 |
15 |
$67K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
4,396 |
3,814 |
$58K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
657 |
619 |
$56K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
1,820 |
1,289 |
$55K |
| 94010 |
|
1,524 |
1,383 |
$43K |
| 95165 |
Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials |
363 |
333 |
$42K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,079 |
977 |
$37K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
3,290 |
3,023 |
$33K |
| 31231 |
|
734 |
648 |
$32K |
| 95115 |
|
2,091 |
1,219 |
$18K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
450 |
402 |
$17K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,293 |
1,170 |
$16K |
| 90651 |
|
808 |
755 |
$15K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
894 |
438 |
$14K |
| 99174 |
|
746 |
681 |
$11K |
| 90686 |
|
5,278 |
4,771 |
$11K |
| 99000 |
|
3,689 |
3,298 |
$10K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
107 |
81 |
$9K |
| 99215 |
Prolong outpt/office vis |
97 |
84 |
$8K |
| 92563 |
|
313 |
272 |
$8K |
| 90670 |
|
1,337 |
1,220 |
$7K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
241 |
146 |
$6K |
| 17110 |
|
199 |
137 |
$4K |
| 94760 |
|
1,867 |
1,532 |
$4K |
| 90734 |
|
259 |
243 |
$3K |
| H0049 |
Alcohol and/or drug screening |
312 |
278 |
$3K |
| 81002 |
|
866 |
729 |
$2K |
| 36416 |
|
954 |
813 |
$2K |
| 96401 |
|
57 |
28 |
$2K |
| 85018 |
|
784 |
720 |
$2K |
| 36415 |
Collection of venous blood by venipuncture |
659 |
597 |
$2K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
75 |
52 |
$1K |
| 90461 |
|
2,270 |
2,133 |
$1K |
| 90621 |
|
40 |
40 |
$984.33 |
| 99402 |
|
14 |
14 |
$787.36 |
| 81003 |
|
408 |
364 |
$756.04 |
| 90680 |
|
256 |
228 |
$613.81 |
| 90715 |
|
135 |
124 |
$593.73 |
| 96127 |
|
42 |
32 |
$572.33 |
| 90698 |
|
345 |
318 |
$480.99 |
| 90716 |
|
80 |
66 |
$455.26 |
| 90474 |
|
39 |
38 |
$425.22 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
249 |
137 |
$367.12 |
| 90619 |
|
14 |
12 |
$356.60 |
| 90707 |
|
83 |
70 |
$347.91 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
14 |
12 |
$340.67 |
| 92551 |
|
29 |
29 |
$305.37 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
61 |
41 |
$177.79 |
| 96361 |
Intravenous infusion, hydration; each additional hour |
20 |
12 |
$138.93 |
| 90633 |
|
447 |
399 |
$117.89 |
| 99050 |
|
14 |
14 |
$101.36 |
| 90744 |
|
101 |
85 |
$59.40 |
| 90685 |
|
319 |
254 |
$44.62 |
| 99072 |
|
354 |
337 |
$40.00 |
| 90647 |
|
39 |
25 |
$0.00 |
| 90710 |
|
52 |
51 |
$0.00 |