| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,145 |
3,014 |
$98K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,923 |
1,853 |
$92K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,637 |
1,042 |
$23K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
408 |
369 |
$17K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
100 |
100 |
$7K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
120 |
112 |
$6K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
110 |
108 |
$5K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
25 |
25 |
$4K |
| 90686 |
|
537 |
535 |
$3K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
25 |
24 |
$2K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
28 |
24 |
$2K |
| 85018 |
|
564 |
560 |
$1K |
| 71045 |
Radiologic examination, chest; single view |
126 |
123 |
$1K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
24 |
24 |
$969.12 |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
12 |
12 |
$964.95 |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
24 |
24 |
$786.00 |
| 31231 |
|
12 |
12 |
$661.19 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
30 |
26 |
$589.32 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
72 |
61 |
$494.16 |
| 90670 |
|
29 |
29 |
$144.13 |
| 90633 |
|
27 |
27 |
$81.04 |
| 90461 |
|
288 |
146 |
$0.00 |
| 90688 |
|
15 |
15 |
$0.00 |