| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
7,400 |
6,771 |
$554K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
9,384 |
8,323 |
$515K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,200 |
1,978 |
$146K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,619 |
1,585 |
$109K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
627 |
604 |
$40K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
717 |
609 |
$36K |
| 90670 |
|
1,504 |
1,483 |
$29K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,207 |
1,155 |
$25K |
| 90648 |
|
1,164 |
1,148 |
$23K |
| 90723 |
|
1,062 |
1,052 |
$21K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,487 |
1,438 |
$20K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,930 |
1,887 |
$19K |
| 90680 |
|
898 |
888 |
$17K |
| 99460 |
|
220 |
199 |
$17K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
221 |
215 |
$14K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
213 |
194 |
$13K |
| 99462 |
|
318 |
176 |
$12K |
| 90686 |
|
553 |
544 |
$11K |
| 84443 |
Thyroid stimulating hormone (TSH) |
531 |
503 |
$9K |
| 90633 |
|
426 |
423 |
$8K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
191 |
175 |
$8K |
| 90710 |
|
398 |
393 |
$8K |
| 92551 |
|
1,596 |
1,553 |
$8K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
977 |
900 |
$7K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
817 |
765 |
$6K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
100 |
83 |
$6K |
| 90647 |
|
241 |
240 |
$5K |
| 76801 |
|
153 |
94 |
$5K |
| 80061 |
Lipid panel |
493 |
458 |
$4K |
| 36415 |
Collection of venous blood by venipuncture |
2,715 |
2,492 |
$4K |
| 59025 |
Fetal non-stress test |
180 |
59 |
$4K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
666 |
616 |
$4K |
| 83655 |
|
249 |
239 |
$4K |
| 90620 |
|
160 |
155 |
$3K |
| 87807 |
|
299 |
290 |
$3K |
| 80076 |
|
530 |
489 |
$3K |
| 82950 |
|
442 |
434 |
$2K |
| 90688 |
|
155 |
145 |
$2K |
| 36416 |
|
736 |
665 |
$2K |
| 81001 |
|
473 |
450 |
$2K |
| 90715 |
|
84 |
81 |
$2K |
| 90734 |
|
76 |
76 |
$1K |
| 90461 |
|
40 |
40 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
14 |
14 |
$1K |
| 90700 |
|
69 |
69 |
$1K |
| 80053 |
Comprehensive metabolic panel |
165 |
151 |
$1K |
| 90696 |
|
60 |
59 |
$1K |
| 99215 |
Prolong outpt/office vis |
12 |
12 |
$935.16 |
| 96161 |
|
278 |
240 |
$793.80 |
| G9357 |
Post-partum screenings, evaluations and education performed |
16 |
12 |
$700.00 |
| 99173 |
|
141 |
136 |
$650.16 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
95 |
92 |
$540.00 |
| 90649 |
|
25 |
25 |
$494.75 |
| 80305 |
|
46 |
46 |
$460.68 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
26 |
25 |
$424.42 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
104 |
100 |
$415.00 |
| D1206 |
Topical application of fluoride varnish |
28 |
28 |
$396.00 |
| 96127 |
|
122 |
116 |
$340.08 |
| 84439 |
|
54 |
48 |
$306.00 |
| 90685 |
|
15 |
15 |
$296.85 |
| 90651 |
|
13 |
13 |
$257.27 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
45 |
42 |
$166.09 |
| 82947 |
|
100 |
91 |
$104.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
44 |
42 |
$79.92 |
| 81025 |
|
19 |
19 |
$54.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
87 |
80 |
$21.88 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
12 |
12 |
$12.92 |
| G0008 |
Administration of influenza virus vaccine |
39 |
37 |
$5.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
422 |
352 |
$0.00 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
101 |
99 |
$0.00 |
| 99401 |
|
706 |
545 |
$0.00 |
| 3078F |
|
144 |
127 |
$0.00 |
| 3074F |
|
136 |
125 |
$0.00 |
| 99308 |
Subsequent nursing facility care, per day, straightforward |
78 |
63 |
$0.00 |
| 3079F |
|
13 |
12 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
31 |
28 |
$0.00 |