| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,877 |
2,539 |
$127K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,463 |
1,348 |
$48K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
638 |
617 |
$13K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
863 |
827 |
$10K |
| 36415 |
Collection of venous blood by venipuncture |
2,755 |
2,488 |
$5K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
136 |
131 |
$5K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
48 |
48 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
83 |
79 |
$2K |
| 90686 |
|
406 |
399 |
$2K |
| 80053 |
Comprehensive metabolic panel |
211 |
205 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
344 |
252 |
$2K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
307 |
297 |
$2K |
| 99215 |
Prolong outpt/office vis |
16 |
15 |
$2K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
40 |
40 |
$1K |
| 92551 |
|
272 |
264 |
$1K |
| 99188 |
|
233 |
230 |
$1K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
74 |
68 |
$925.77 |
| 84443 |
Thyroid stimulating hormone (TSH) |
85 |
79 |
$744.07 |
| 90461 |
|
40 |
39 |
$728.05 |
| 99442 |
|
25 |
13 |
$573.24 |
| 99173 |
|
292 |
283 |
$299.64 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
113 |
102 |
$220.76 |
| 85027 |
|
17 |
14 |
$104.70 |
| 99606 |
|
17 |
12 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
20 |
15 |
$0.00 |
| 85018 |
|
19 |
13 |
$0.00 |
| X5622 |
|
542 |
537 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
34 |
14 |
$0.00 |
| 90648 |
|
12 |
12 |
$0.00 |
| 90685 |
|
18 |
18 |
$0.00 |