| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
20,423 |
17,180 |
$8.77M |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
4,957 |
4,331 |
$2.69M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,725 |
4,970 |
$2.64M |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
6,739 |
4,689 |
$1.54M |
| A0425 |
Ground mileage, per statute mile |
3,474 |
2,860 |
$759K |
| 99215 |
Prolong outpt/office vis |
1,031 |
965 |
$548K |
| S0215 |
Non-emergency transportation; mileage, per mile |
3,478 |
1,524 |
$458K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
628 |
292 |
$345K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
545 |
532 |
$301K |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
1,844 |
1,136 |
$255K |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
1,470 |
971 |
$233K |
| W0037 |
|
7,811 |
7,811 |
$190K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
138 |
137 |
$85K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
1,788 |
1,326 |
$81K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
277 |
258 |
$80K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
105 |
96 |
$58K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
90 |
90 |
$51K |
| A0380 |
Bls mileage (per mile) |
155 |
145 |
$35K |
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
280 |
186 |
$29K |
| A0120 |
Non-emergency transportation: mini-bus, mountain area transports, or other transportation systems |
2,110 |
1,635 |
$20K |
| A0390 |
Als mileage (per mile) |
71 |
65 |
$19K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
29 |
29 |
$17K |
| 92002 |
|
19 |
19 |
$12K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
1,688 |
997 |
$7K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
74 |
52 |
$7K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
49 |
47 |
$3K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
28 |
24 |
$3K |
| 0001A |
|
303 |
247 |
$1K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
38 |
37 |
$738.55 |
| 0012A |
|
49 |
48 |
$519.00 |
| 98966 |
|
21 |
20 |
$301.77 |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
14 |
12 |
$117.70 |
| 71046 |
Radiologic examination, chest; 2 views |
114 |
69 |
$63.29 |
| G0008 |
Administration of influenza virus vaccine |
100 |
33 |
$0.00 |
| 0011A |
|
63 |
46 |
$0.00 |
| 80053 |
Comprehensive metabolic panel |
28 |
23 |
$0.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
50 |
43 |
$0.00 |
| 84443 |
Thyroid stimulating hormone (TSH) |
22 |
19 |
$0.00 |
| 90686 |
|
21 |
20 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
35 |
25 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
22 |
19 |
$0.00 |
| 0501F |
|
33 |
14 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
22 |
22 |
$0.00 |
| 0502F |
|
31 |
13 |
$0.00 |
| 0002A |
|
269 |
192 |
$0.00 |
| 91300 |
|
33 |
32 |
$0.00 |
| 81003 |
|
26 |
20 |
$0.00 |