| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,385 |
5,090 |
$317K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
980 |
980 |
$74K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
703 |
677 |
$59K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
832 |
831 |
$56K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
468 |
468 |
$36K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,163 |
1,147 |
$24K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
218 |
218 |
$17K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
811 |
811 |
$11K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,177 |
1,175 |
$9K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
662 |
652 |
$9K |
| 87428 |
|
317 |
315 |
$8K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
229 |
228 |
$6K |
| 99000 |
|
568 |
553 |
$5K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
262 |
243 |
$3K |
| 96127 |
|
598 |
543 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
48 |
47 |
$1K |
| 99051 |
|
240 |
234 |
$1K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
60 |
58 |
$983.67 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
83 |
83 |
$547.08 |
| 90473 |
|
167 |
167 |
$493.20 |
| 99177 |
|
429 |
429 |
$468.58 |
| 83655 |
|
39 |
39 |
$418.32 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
29 |
28 |
$252.29 |
| 36416 |
|
43 |
43 |
$45.00 |
| 81002 |
|
14 |
14 |
$34.59 |
| 2000F |
|
709 |
667 |
$5.87 |
| 3008F |
|
104 |
104 |
$0.62 |
| 90686 |
|
841 |
841 |
$0.10 |
| 3074F |
|
708 |
664 |
$0.01 |
| 3078F |
|
707 |
665 |
$0.01 |
| 90698 |
|
525 |
524 |
$0.00 |
| 91307 |
|
42 |
42 |
$0.00 |
| 90744 |
|
65 |
65 |
$0.00 |
| 90680 |
|
258 |
258 |
$0.00 |
| 90697 |
|
25 |
25 |
$0.00 |
| Q3014 |
Telehealth originating site facility fee |
13 |
13 |
$0.00 |
| 90651 |
|
12 |
12 |
$0.00 |
| 90670 |
|
696 |
695 |
$0.00 |
| G9920 |
Screening performed and negative |
79 |
78 |
$0.00 |
| 90633 |
|
128 |
128 |
$0.00 |
| 99072 |
|
170 |
170 |
$0.00 |
| 90685 |
|
79 |
79 |
$0.00 |