| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
6,455 |
5,832 |
$324K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,677 |
5,193 |
$194K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
471 |
466 |
$20K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
667 |
652 |
$14K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
155 |
153 |
$8K |
| 36415 |
Collection of venous blood by venipuncture |
2,616 |
2,186 |
$3K |
| 90461 |
|
130 |
121 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
199 |
193 |
$1K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
414 |
350 |
$1K |
| 92551 |
|
152 |
151 |
$1K |
| 99215 |
Prolong outpt/office vis |
17 |
12 |
$934.24 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
27 |
27 |
$786.89 |
| 96127 |
|
160 |
160 |
$746.36 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
15 |
15 |
$720.80 |
| 80053 |
Comprehensive metabolic panel |
121 |
105 |
$638.62 |
| 85027 |
|
302 |
231 |
$577.79 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
147 |
143 |
$449.21 |
| 84443 |
Thyroid stimulating hormone (TSH) |
24 |
23 |
$412.86 |
| 99173 |
|
199 |
196 |
$295.70 |
| 90686 |
|
234 |
231 |
$273.39 |
| G2211 |
Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) |
69 |
64 |
$224.78 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
15 |
14 |
$120.35 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
13 |
12 |
$91.92 |
| 99188 |
|
12 |
12 |
$13.48 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
12 |
12 |
$12.94 |
| 81001 |
|
30 |
30 |
$4.27 |
| 80061 |
Lipid panel |
68 |
67 |
$0.00 |
| X5622 |
|
321 |
289 |
$0.00 |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
57 |
24 |
$0.00 |
| 90670 |
|
13 |
13 |
$0.00 |
| 90656 |
|
33 |
33 |
$0.00 |
| 90688 |
|
12 |
12 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
12 |
12 |
$0.00 |