| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
7,967 |
5,786 |
$605K |
| 99215 |
Prolong outpt/office vis |
4,458 |
2,794 |
$424K |
| 99199 |
Unlisted special service, procedure or report |
66,292 |
40,080 |
$383K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,931 |
3,141 |
$203K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,521 |
1,112 |
$121K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,257 |
950 |
$97K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,234 |
884 |
$93K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
5,514 |
3,639 |
$78K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
2,780 |
1,895 |
$70K |
| D0145 |
Oral evaluation for a patient under three years of age |
1,253 |
915 |
$38K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
445 |
336 |
$37K |
| 99205 |
Prolong outpt/office vis |
198 |
120 |
$26K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,721 |
620 |
$19K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
2,906 |
1,907 |
$18K |
| D1206 |
Topical application of fluoride varnish |
1,178 |
852 |
$16K |
| 96127 |
|
3,241 |
2,128 |
$12K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
852 |
620 |
$10K |
| 92551 |
|
3,272 |
2,204 |
$9K |
| 99406 |
|
1,796 |
1,027 |
$9K |
| 99408 |
|
1,012 |
572 |
$9K |
| 90671 |
|
137 |
124 |
$9K |
| 99354 |
|
84 |
62 |
$6K |
| 90474 |
|
325 |
219 |
$5K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
95 |
38 |
$5K |
| 90686 |
|
1,656 |
1,048 |
$3K |
| 90651 |
|
214 |
136 |
$3K |
| 90670 |
|
796 |
502 |
$2K |
| 99173 |
|
3,365 |
2,274 |
$1K |
| 90723 |
|
496 |
346 |
$1K |
| 96161 |
|
743 |
543 |
$1K |
| 2014F |
|
798 |
608 |
$940.17 |
| 90734 |
|
144 |
63 |
$873.90 |
| 83655 |
|
53 |
41 |
$774.96 |
| 81002 |
|
274 |
173 |
$537.14 |
| 90647 |
|
550 |
369 |
$441.74 |
| 90680 |
|
315 |
206 |
$380.84 |
| 90715 |
|
38 |
24 |
$375.35 |
| 85018 |
|
198 |
116 |
$352.70 |
| 90710 |
|
105 |
64 |
$275.16 |
| 0513F |
|
63 |
39 |
$120.00 |
| 36415 |
Collection of venous blood by venipuncture |
37 |
33 |
$86.40 |
| 2015F |
|
25 |
16 |
$80.00 |
| 3085F |
|
16 |
12 |
$40.00 |
| 94760 |
|
68 |
58 |
$6.21 |
| G8482 |
Influenza immunization administered or previously received |
321 |
243 |
$0.25 |
| 90633 |
|
147 |
98 |
$0.01 |
| G9903 |
Patient screened for tobacco use and identified as a tobacco non-user |
119 |
68 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
357 |
248 |
$0.00 |
| 90696 |
|
17 |
12 |
$0.00 |
| 90677 |
|
41 |
39 |
$0.00 |
| 3008F |
|
84 |
71 |
$0.00 |
| G9902 |
Patient screened for tobacco use and identified as a tobacco user |
54 |
41 |
$0.00 |
| 1036F |
|
62 |
47 |
$0.00 |
| 90688 |
|
18 |
16 |
$0.00 |
| 3078F |
|
4,419 |
3,016 |
$0.00 |
| G8483 |
Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons) |
316 |
214 |
$0.00 |
| 90685 |
|
20 |
16 |
$0.00 |