| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
32,196 |
26,121 |
$2.07M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
10,390 |
9,505 |
$1.01M |
| 95165 |
Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials |
123 |
123 |
$52K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
5,011 |
4,934 |
$29K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
229 |
229 |
$21K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,787 |
1,696 |
$18K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
231 |
223 |
$17K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
888 |
619 |
$14K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
165 |
165 |
$13K |
| 96127 |
|
2,573 |
2,566 |
$11K |
| 95115 |
|
1,269 |
457 |
$11K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
103 |
103 |
$10K |
| 87081 |
|
1,896 |
1,875 |
$8K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
496 |
257 |
$7K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
65 |
65 |
$5K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
58 |
57 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
50 |
50 |
$5K |
| A4927 |
Gloves, non-sterile, per 100 |
1,021 |
944 |
$4K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
95 |
94 |
$4K |
| 99051 |
|
221 |
200 |
$2K |
| 81002 |
|
1,361 |
1,322 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
14 |
14 |
$2K |
| 93000 |
|
171 |
164 |
$2K |
| 0012A |
|
34 |
34 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
218 |
211 |
$800.40 |
| 0011A |
|
20 |
20 |
$723.14 |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
25 |
25 |
$653.37 |
| 86580 |
|
90 |
89 |
$590.86 |
| 81001 |
|
166 |
166 |
$459.65 |
| 90686 |
|
1,651 |
1,648 |
$451.40 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
74 |
74 |
$395.00 |
| 87420 |
|
54 |
54 |
$340.33 |
| 92552 |
|
20 |
20 |
$287.87 |
| 82947 |
|
73 |
64 |
$269.42 |
| 87110 |
|
41 |
41 |
$239.50 |
| 88142 |
|
12 |
12 |
$191.19 |
| 90461 |
|
15 |
15 |
$135.00 |
| 90688 |
|
15 |
15 |
$40.36 |
| 81025 |
|
16 |
16 |
$25.48 |
| 99173 |
|
59 |
58 |
$3.18 |
| 80053 |
Comprehensive metabolic panel |
299 |
295 |
$1.09 |
| 99000 |
|
1,918 |
1,898 |
$0.00 |
| 90698 |
|
187 |
185 |
$0.00 |
| 90744 |
|
45 |
44 |
$0.00 |
| 90677 |
|
136 |
136 |
$0.00 |
| 91301 |
|
50 |
48 |
$0.00 |
| A4556 |
Electrodes, (e.g., apnea monitor), per pair |
17 |
16 |
$0.00 |
| 90648 |
|
105 |
105 |
$0.00 |
| 90670 |
|
458 |
456 |
$0.00 |
| 90681 |
|
75 |
75 |
$0.00 |
| 90633 |
|
27 |
27 |
$0.00 |