| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
13,504 |
12,479 |
$183K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,135 |
3,995 |
$73K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,430 |
2,235 |
$72K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
8,054 |
8,036 |
$55K |
| 96127 |
|
5,156 |
4,792 |
$54K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
4,438 |
3,896 |
$47K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
2,492 |
2,429 |
$37K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
3,887 |
3,850 |
$28K |
| 92588 |
|
1,020 |
928 |
$28K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
8,557 |
5,196 |
$27K |
| 99188 |
|
785 |
785 |
$21K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,401 |
796 |
$21K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
587 |
584 |
$19K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
583 |
580 |
$19K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,904 |
1,903 |
$15K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,554 |
1,553 |
$14K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,891 |
1,891 |
$14K |
| 83655 |
|
1,286 |
1,285 |
$14K |
| 99215 |
Prolong outpt/office vis |
79 |
79 |
$9K |
| 99381 |
|
81 |
78 |
$6K |
| 82465 |
|
1,164 |
1,163 |
$6K |
| 99460 |
|
58 |
58 |
$6K |
| 95930 |
|
67 |
46 |
$6K |
| 87081 |
|
932 |
921 |
$5K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
288 |
286 |
$5K |
| 87070 |
|
286 |
280 |
$4K |
| 99050 |
|
290 |
290 |
$3K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
543 |
533 |
$3K |
| 86003 |
|
15 |
12 |
$2K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
38 |
35 |
$2K |
| 99173 |
|
1,156 |
1,151 |
$2K |
| 90461 |
|
95 |
95 |
$1K |
| 81002 |
|
439 |
435 |
$1K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
32 |
30 |
$1K |
| 92555 |
|
62 |
62 |
$1K |
| 87807 |
|
95 |
94 |
$1K |
| 90621 |
|
57 |
57 |
$969.70 |
| 81025 |
|
104 |
103 |
$779.42 |
| 90651 |
|
275 |
273 |
$720.00 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
81 |
81 |
$713.11 |
| 82947 |
|
156 |
154 |
$672.03 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
21 |
20 |
$429.45 |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
12 |
12 |
$406.56 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
183 |
183 |
$343.86 |
| 90658 |
|
18 |
18 |
$293.76 |
| 90480 |
|
16 |
16 |
$275.22 |
| 94010 |
|
12 |
12 |
$250.80 |
| 36415 |
Collection of venous blood by venipuncture |
36 |
36 |
$243.74 |
| 90686 |
|
608 |
608 |
$180.00 |
| 87210 |
|
15 |
14 |
$66.00 |
| 96161 |
|
75 |
75 |
$43.25 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
12 |
12 |
$18.35 |
| 96160 |
|
26 |
26 |
$2.03 |
| 99072 |
|
505 |
435 |
$0.29 |
| 90710 |
|
233 |
230 |
$0.00 |
| 90633 |
|
333 |
324 |
$0.00 |
| 90700 |
|
92 |
92 |
$0.00 |
| 90661 |
|
110 |
110 |
$0.00 |
| 90648 |
|
38 |
33 |
$0.00 |
| 90670 |
|
48 |
48 |
$0.00 |
| 90715 |
|
56 |
56 |
$0.00 |
| 90656 |
|
458 |
428 |
$0.00 |
| 90619 |
|
485 |
482 |
$0.00 |
| 90677 |
|
569 |
564 |
$0.00 |
| 90698 |
|
53 |
53 |
$0.00 |
| 90680 |
|
352 |
350 |
$0.00 |
| 90697 |
|
343 |
341 |
$0.00 |
| 90674 |
|
12 |
12 |
$0.00 |
| 90696 |
|
13 |
12 |
$0.00 |
| 90744 |
|
12 |
12 |
$0.00 |