| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
11,610 |
9,773 |
$1.89M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
8,394 |
7,112 |
$1.65M |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
4,140 |
3,499 |
$511K |
| G0467 |
Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit |
1,523 |
1,344 |
$148K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
374 |
313 |
$69K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
348 |
295 |
$61K |
| S0281 |
Medical home program, comprehensive care coordination and planning, maintenance of plan |
4,689 |
4,138 |
$54K |
| X5622 |
|
145 |
125 |
$36K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
127 |
111 |
$26K |
| 99215 |
Prolong outpt/office vis |
39 |
37 |
$10K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
30 |
28 |
$6K |
| 93000 |
|
13 |
12 |
$3K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
13 |
13 |
$3K |
| 99188 |
|
286 |
252 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
7,592 |
6,359 |
$2K |
| 91306 |
|
126 |
120 |
$895.65 |
| 90750 |
|
62 |
57 |
$818.89 |
| 36415 |
Collection of venous blood by venipuncture |
6,554 |
5,349 |
$698.93 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
3,928 |
3,366 |
$629.88 |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
477 |
363 |
$625.00 |
| 90686 |
|
3,196 |
2,828 |
$494.75 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,969 |
1,707 |
$218.17 |
| 91322 |
|
18 |
13 |
$147.00 |
| 90656 |
|
456 |
250 |
$116.07 |
| 82043 |
|
196 |
184 |
$54.59 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
445 |
387 |
$43.26 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
887 |
765 |
$39.90 |
| 36416 |
|
1,494 |
1,208 |
$24.56 |
| 96127 |
|
996 |
846 |
$9.14 |
| 92551 |
|
1,506 |
1,273 |
$8.85 |
| 90670 |
|
42 |
39 |
$0.00 |
| 99173 |
|
1,439 |
1,213 |
$0.00 |
| 90734 |
|
104 |
88 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
18 |
13 |
$0.00 |
| 90715 |
|
168 |
144 |
$0.00 |
| 90633 |
|
17 |
13 |
$0.00 |
| 91300 |
|
15 |
12 |
$0.00 |
| 82947 |
|
17 |
12 |
$0.00 |
| 90710 |
|
17 |
14 |
$0.00 |
| 85018 |
|
376 |
272 |
$0.00 |
| 90651 |
|
112 |
95 |
$0.00 |
| 0064A |
|
126 |
120 |
$0.00 |
| 0011A |
|
86 |
85 |
$0.00 |
| 91301 |
|
390 |
366 |
$0.00 |