| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,701 |
2,348 |
$183K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,023 |
1,010 |
$24K |
| 92587 |
|
855 |
843 |
$17K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
168 |
164 |
$17K |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
234 |
234 |
$16K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
141 |
141 |
$12K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
141 |
141 |
$10K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
127 |
127 |
$10K |
| H0049 |
Alcohol and/or drug screening |
277 |
277 |
$5K |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
304 |
304 |
$4K |
| 99401 |
|
205 |
204 |
$4K |
| 90461 |
|
139 |
139 |
$3K |
| G0444 |
Annual depression screening, 5 to 15 minutes |
267 |
266 |
$3K |
| 36415 |
Collection of venous blood by venipuncture |
671 |
669 |
$2K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
232 |
232 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
149 |
148 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
12 |
12 |
$1K |
| 90619 |
|
13 |
13 |
$951.10 |
| 97802 |
|
354 |
354 |
$385.76 |
| 87430 |
|
88 |
88 |
$363.50 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
29 |
28 |
$335.53 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
30 |
30 |
$285.61 |
| 92567 |
|
13 |
13 |
$173.42 |
| 92568 |
|
13 |
13 |
$160.94 |
| 99441 |
|
12 |
12 |
$147.05 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
17 |
17 |
$124.95 |
| 99051 |
|
68 |
67 |
$121.16 |
| 96127 |
|
32 |
31 |
$105.31 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
24 |
24 |
$71.40 |
| 90656 |
|
265 |
265 |
$23.53 |
| 3016F |
|
42 |
42 |
$0.00 |
| S9451 |
Exercise classes, non-physician provider, per session |
201 |
201 |
$0.00 |
| 90686 |
|
86 |
83 |
$0.00 |
| 90674 |
|
20 |
20 |
$0.00 |
| 1220F |
|
42 |
42 |
$0.00 |
| 3008F |
|
128 |
128 |
$0.00 |
| A4930 |
Gloves, sterile, per pair |
13 |
13 |
$0.00 |
| 1000F |
|
42 |
42 |
$0.00 |