| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
368 |
304 |
$50K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
273 |
179 |
$31K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
12,717 |
9,849 |
$30K |
| 90834 |
Psychotherapy, 45 minutes with patient |
5,458 |
3,999 |
$15K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
6,499 |
5,629 |
$8K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
94 |
71 |
$6K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
86,924 |
61,308 |
$5K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
42 |
38 |
$5K |
| 71046 |
Radiologic examination, chest; 2 views |
7,901 |
6,888 |
$4K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
34,516 |
28,231 |
$4K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
3,498 |
3,080 |
$3K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
96 |
86 |
$2K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,651 |
2,379 |
$1K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
17 |
16 |
$934.72 |
| 92015 |
Determination of refractive state |
36 |
36 |
$670.54 |
| 0001A |
|
12 |
12 |
$583.47 |
| 0002A |
|
19 |
19 |
$406.21 |
| D1206 |
Topical application of fluoride varnish |
13 |
13 |
$405.45 |
| 72040 |
|
7,003 |
5,757 |
$311.40 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
5,515 |
4,790 |
$255.57 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
12 |
12 |
$125.63 |
| D0120 |
Periodic oral evaluation - established patient |
13,808 |
11,759 |
$48.45 |
| 99605 |
|
38 |
18 |
$0.00 |
| 74018 |
|
37 |
34 |
$0.00 |
| 70010 |
|
88 |
78 |
$0.00 |
| 91300 |
|
14 |
14 |
$0.00 |
| 70450 |
Computed tomography, head or brain; without contrast material |
16 |
14 |
$0.00 |
| 71020 |
|
357 |
309 |
$0.00 |
| 97162 |
|
479 |
188 |
$0.00 |
| 90686 |
|
13 |
13 |
$0.00 |
| 74160 |
|
14 |
14 |
$0.00 |