| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,200 |
3,548 |
$177K |
| S0281 |
Medical home program, comprehensive care coordination and planning, maintenance of plan |
553 |
505 |
$121K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,471 |
1,342 |
$38K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
750 |
713 |
$6K |
| 80061 |
Lipid panel |
378 |
368 |
$4K |
| 36415 |
Collection of venous blood by venipuncture |
1,952 |
1,772 |
$3K |
| 80053 |
Comprehensive metabolic panel |
481 |
442 |
$3K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
134 |
132 |
$3K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
24 |
24 |
$2K |
| 84443 |
Thyroid stimulating hormone (TSH) |
272 |
253 |
$2K |
| 90686 |
|
265 |
256 |
$1K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
162 |
160 |
$1K |
| 99442 |
|
43 |
18 |
$1K |
| 90682 |
|
36 |
36 |
$1K |
| 90834 |
Psychotherapy, 45 minutes with patient |
13 |
13 |
$774.48 |
| 80050 |
General health panel |
25 |
24 |
$668.67 |
| 99441 |
|
46 |
26 |
$617.17 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
264 |
239 |
$539.09 |
| 96127 |
|
115 |
101 |
$403.36 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
26 |
24 |
$394.01 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
25 |
25 |
$370.67 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
34 |
34 |
$251.41 |
| 92551 |
|
85 |
85 |
$243.18 |
| 90662 |
|
19 |
16 |
$196.00 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
17 |
16 |
$145.14 |
| G0008 |
Administration of influenza virus vaccine |
50 |
39 |
$142.58 |
| 85027 |
|
27 |
26 |
$105.44 |
| 82043 |
|
12 |
12 |
$74.02 |
| 99173 |
|
75 |
75 |
$50.04 |
| S0280 |
Medical home program, comprehensive care coordination and planning, initial plan |
44 |
39 |
$0.00 |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
12 |
12 |
$0.00 |
| X5622 |
|
132 |
131 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
12 |
12 |
$0.00 |