| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
14,691 |
12,540 |
$820K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
6,394 |
5,568 |
$510K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,993 |
1,986 |
$144K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,434 |
1,365 |
$98K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,344 |
1,344 |
$94K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
6,139 |
6,003 |
$53K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
379 |
379 |
$27K |
| 92551 |
|
3,133 |
3,118 |
$20K |
| 99050 |
|
1,350 |
1,265 |
$8K |
| 99401 |
|
977 |
932 |
$5K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
4,309 |
4,271 |
$5K |
| 99402 |
|
320 |
297 |
$4K |
| 92550 |
|
369 |
321 |
$4K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
619 |
599 |
$3K |
| 83655 |
|
169 |
169 |
$2K |
| A4245 |
Alcohol wipes, per box |
2,000 |
1,940 |
$2K |
| 90461 |
|
1,149 |
1,145 |
$2K |
| 36415 |
Collection of venous blood by venipuncture |
3,418 |
3,400 |
$1K |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
12 |
12 |
$1K |
| 90620 |
|
69 |
69 |
$743.40 |
| 87070 |
|
89 |
88 |
$629.57 |
| 99173 |
|
2,197 |
2,196 |
$628.62 |
| 99051 |
|
115 |
115 |
$610.04 |
| 36410 |
|
72 |
72 |
$498.24 |
| A4208 |
Syringe with needle, sterile 3 cc, each |
2,000 |
1,940 |
$363.93 |
| 92553 |
|
19 |
16 |
$359.72 |
| 97802 |
|
697 |
696 |
$239.94 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
13 |
13 |
$178.38 |
| 90474 |
|
12 |
12 |
$85.20 |
| 90658 |
|
734 |
728 |
$56.64 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
13 |
13 |
$43.68 |
| 96127 |
|
13 |
13 |
$3.36 |
| 90744 |
|
85 |
85 |
$0.00 |
| 90696 |
|
14 |
14 |
$0.00 |
| 90686 |
|
107 |
107 |
$0.00 |
| 3008F |
|
17 |
17 |
$0.00 |
| 99000 |
|
84 |
83 |
$0.00 |
| 90656 |
|
37 |
37 |
$0.00 |
| 90700 |
|
123 |
123 |
$0.00 |
| 90670 |
|
422 |
419 |
$0.00 |
| 90713 |
|
12 |
12 |
$0.00 |
| 90633 |
|
28 |
28 |
$0.00 |
| 90648 |
|
118 |
117 |
$0.00 |
| A4927 |
Gloves, non-sterile, per 100 |
33 |
33 |
$0.00 |
| 90710 |
|
54 |
54 |
$0.00 |
| 90715 |
|
14 |
14 |
$0.00 |