| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
727 |
670 |
$41K |
| 86480 |
|
429 |
429 |
$21K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
254 |
222 |
$9K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
302 |
302 |
$8K |
| 90707 |
|
196 |
196 |
$7K |
| 86704 |
|
475 |
475 |
$6K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
378 |
378 |
$6K |
| 87340 |
|
476 |
475 |
$6K |
| 90714 |
|
216 |
216 |
$5K |
| 86708 |
|
319 |
319 |
$4K |
| 86787 |
|
299 |
299 |
$4K |
| 86803 |
|
254 |
254 |
$4K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
46 |
46 |
$4K |
| 90716 |
|
76 |
76 |
$4K |
| 90715 |
|
149 |
149 |
$3K |
| 86706 |
|
263 |
263 |
$3K |
| 90651 |
|
31 |
31 |
$3K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
224 |
214 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
31 |
27 |
$2K |
| 90746 |
|
42 |
42 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
18 |
18 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
14 |
14 |
$1K |
| 90688 |
|
213 |
213 |
$1K |
| 36415 |
Collection of venous blood by venipuncture |
548 |
547 |
$1K |
| Q2039 |
Influenza virus vaccine, not otherwise specified |
67 |
67 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
12 |
12 |
$983.28 |
| 90744 |
|
111 |
111 |
$722.10 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
48 |
47 |
$628.03 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
40 |
40 |
$600.00 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
40 |
40 |
$600.00 |
| 90713 |
|
81 |
81 |
$482.76 |
| 90756 |
|
27 |
27 |
$405.00 |
| 86735 |
|
25 |
25 |
$368.25 |
| 90633 |
|
59 |
59 |
$351.64 |
| S9430 |
Pharmacy compounding and dispensing services |
13 |
13 |
$299.00 |
| 81025 |
|
68 |
65 |
$272.00 |
| 90710 |
|
39 |
39 |
$232.44 |
| 90670 |
|
38 |
38 |
$226.48 |
| 86765 |
|
13 |
13 |
$189.02 |
| 90686 |
|
30 |
30 |
$178.80 |
| 86762 |
|
12 |
12 |
$178.32 |
| 90723 |
|
16 |
16 |
$95.36 |
| 85018 |
|
30 |
30 |
$80.10 |
| 90734 |
|
13 |
13 |
$77.48 |
| J3490 |
Unclassified drugs |
13 |
13 |
$64.00 |
| 86592 |
|
13 |
13 |
$62.66 |