| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
9,523 |
7,702 |
$276K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,266 |
2,999 |
$106K |
| 99215 |
Prolong outpt/office vis |
675 |
577 |
$11K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
162 |
153 |
$10K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
890 |
787 |
$7K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
625 |
591 |
$6K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
131 |
115 |
$4K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
486 |
134 |
$4K |
| 87428 |
|
49 |
41 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
37 |
37 |
$3K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
64 |
62 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
191 |
169 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
197 |
93 |
$2K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
40 |
37 |
$2K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
297 |
173 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
26 |
26 |
$2K |
| 99222 |
Initial hospital care, per day, moderate complexity |
68 |
67 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
15 |
13 |
$1K |
| 36556 |
|
138 |
128 |
$862.83 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
13 |
12 |
$748.25 |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
13 |
12 |
$611.24 |
| 90686 |
|
16 |
14 |
$240.57 |
| 76937 |
|
337 |
286 |
$131.52 |
| 90688 |
|
65 |
65 |
$91.20 |
| 81002 |
|
1,529 |
1,379 |
$66.03 |
| 77001 |
|
78 |
75 |
$43.29 |
| 1036F |
|
5,918 |
5,097 |
$0.12 |
| 3074F |
|
3,786 |
3,351 |
$0.05 |
| 3078F |
|
2,949 |
2,590 |
$0.05 |
| 1126F |
|
119 |
115 |
$0.00 |
| 3008F |
|
4,899 |
4,312 |
$0.00 |
| 1111F |
|
36 |
31 |
$0.00 |
| 1101F |
|
24 |
24 |
$0.00 |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
12 |
12 |
$0.00 |
| 3079F |
|
32 |
30 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
12 |
12 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
15 |
15 |
$0.00 |
| 99153 |
Mod sedat endo service >5yrs |
28 |
16 |
$0.00 |
| 1170F |
|
24 |
24 |
$0.00 |
| 1160F |
|
3,841 |
3,392 |
$0.00 |
| 1159F |
|
2,966 |
2,637 |
$0.00 |
| 99152 |
|
159 |
142 |
$0.00 |
| 1090F |
|
24 |
24 |
$0.00 |
| 3725F |
|
12 |
12 |
$0.00 |
| G9622 |
Patient not identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method |
12 |
12 |
$0.00 |
| 3288F |
|
12 |
12 |
$0.00 |