| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,470 |
3,763 |
$200K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,222 |
2,840 |
$194K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
462 |
383 |
$8K |
| 99215 |
Prolong outpt/office vis |
80 |
62 |
$8K |
| 87428 |
|
63 |
56 |
$2K |
| 80053 |
Comprehensive metabolic panel |
472 |
340 |
$2K |
| 80061 |
Lipid panel |
339 |
242 |
$2K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
508 |
370 |
$2K |
| 36415 |
Collection of venous blood by venipuncture |
1,812 |
1,270 |
$2K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
169 |
102 |
$2K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
481 |
339 |
$1K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
13 |
12 |
$1K |
| 84443 |
Thyroid stimulating hormone (TSH) |
178 |
125 |
$1K |
| 90682 |
|
35 |
26 |
$1K |
| 90688 |
|
21 |
16 |
$960.00 |
| 99457 |
|
105 |
77 |
$832.41 |
| 90686 |
|
97 |
77 |
$660.00 |
| 96127 |
|
401 |
305 |
$651.70 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
19 |
12 |
$650.35 |
| 96161 |
|
503 |
434 |
$617.16 |
| 99458 |
|
58 |
42 |
$613.04 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
53 |
38 |
$368.26 |
| G2011 |
Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention, 5-14 minutes |
126 |
86 |
$112.14 |
| 99454 |
|
16 |
13 |
$103.68 |
| 96160 |
|
278 |
191 |
$7.85 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
24 |
12 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
19 |
16 |
$0.00 |