| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,083 |
3,754 |
$244K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,815 |
3,576 |
$158K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
470 |
448 |
$44K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
570 |
542 |
$36K |
| 99215 |
Prolong outpt/office vis |
408 |
397 |
$31K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
250 |
248 |
$21K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
174 |
174 |
$17K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,897 |
1,816 |
$14K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
257 |
255 |
$14K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
326 |
177 |
$10K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
913 |
827 |
$10K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
32 |
32 |
$6K |
| 99205 |
Prolong outpt/office vis |
51 |
51 |
$5K |
| 90686 |
|
518 |
517 |
$4K |
| 99222 |
Initial hospital care, per day, moderate complexity |
43 |
43 |
$3K |
| 99223 |
Prolong inpt eval add15 m |
28 |
27 |
$3K |
| 90651 |
|
24 |
24 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
107 |
105 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
107 |
107 |
$1K |
| 99000 |
|
87 |
82 |
$1K |
| 87210 |
|
222 |
215 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
13 |
13 |
$964.68 |
| 90474 |
|
324 |
309 |
$927.00 |
| 99238 |
Hospital discharge day management, 30 minutes or less |
12 |
12 |
$483.60 |
| 51798 |
|
65 |
65 |
$409.99 |
| 81003 |
|
175 |
166 |
$322.63 |
| 99188 |
|
39 |
39 |
$263.34 |
| 90656 |
|
14 |
14 |
$201.15 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
54 |
54 |
$141.68 |
| 96127 |
|
25 |
25 |
$88.64 |
| 81025 |
|
13 |
13 |
$86.96 |
| 81002 |
|
12 |
12 |
$31.25 |
| 90744 |
|
126 |
126 |
$26.90 |
| 90670 |
|
417 |
407 |
$0.00 |
| 90633 |
|
93 |
93 |
$0.00 |
| 90707 |
|
25 |
25 |
$0.00 |
| A9578 |
Injection, gadobenate dimeglumine (multihance multipack), per ml |
48 |
48 |
$0.00 |
| 90685 |
|
15 |
14 |
$0.00 |
| 90680 |
|
252 |
252 |
$0.00 |
| 90698 |
|
367 |
362 |
$0.00 |
| 90716 |
|
12 |
12 |
$0.00 |