| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,714 |
2,387 |
$155K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
705 |
610 |
$27K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
246 |
236 |
$20K |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
975 |
824 |
$17K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
220 |
191 |
$17K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
161 |
150 |
$15K |
| 99385 |
|
63 |
56 |
$5K |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
108 |
73 |
$4K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
38 |
32 |
$3K |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
200 |
156 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
68 |
52 |
$2K |
| 94760 |
|
730 |
673 |
$2K |
| 90651 |
|
236 |
189 |
$1K |
| 90670 |
|
44 |
37 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
15 |
13 |
$994.98 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
51 |
39 |
$975.86 |
| 80305 |
|
51 |
50 |
$975.07 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
85 |
81 |
$878.33 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
49 |
40 |
$679.99 |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
20 |
15 |
$439.07 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
34 |
26 |
$370.26 |
| 90656 |
|
163 |
146 |
$340.74 |
| 99406 |
|
93 |
82 |
$330.14 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
15 |
13 |
$274.42 |
| 87430 |
|
25 |
25 |
$254.70 |
| 99058 |
|
14 |
14 |
$243.48 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
17 |
13 |
$163.87 |
| 90688 |
|
42 |
40 |
$126.44 |
| 93000 |
|
15 |
13 |
$117.16 |
| 81000 |
|
15 |
14 |
$37.86 |
| 81002 |
|
17 |
15 |
$33.07 |
| 3008F |
|
3,488 |
2,924 |
$0.00 |
| 1031F |
|
123 |
98 |
$0.00 |
| 99173 |
|
91 |
84 |
$0.00 |
| 90621 |
|
16 |
12 |
$0.00 |
| 90461 |
|
88 |
78 |
$0.00 |
| 90633 |
|
13 |
12 |
$0.00 |
| 90734 |
|
15 |
12 |
$0.00 |