| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
19,488 |
16,110 |
$13K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,181 |
1,574 |
$7K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,980 |
1,477 |
$3K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
516 |
467 |
$1K |
| G0008 |
Administration of influenza virus vaccine |
44 |
44 |
$260.01 |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
252 |
247 |
$96.60 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
299 |
297 |
$58.47 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
352 |
340 |
$52.44 |
| 90686 |
|
1,205 |
685 |
$42.09 |
| 90656 |
|
411 |
385 |
$20.25 |
| 99385 |
|
656 |
633 |
$2.81 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
476 |
467 |
$2.23 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
466 |
455 |
$2.02 |
| 99386 |
|
317 |
302 |
$1.61 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
169 |
163 |
$1.05 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
104 |
100 |
$0.11 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
87 |
86 |
$0.11 |
| 99173 |
|
1,855 |
1,759 |
$0.00 |
| 1159F |
|
23,971 |
19,744 |
$0.00 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
14 |
14 |
$0.00 |
| 1003F |
|
755 |
258 |
$0.00 |
| 1160F |
|
24,019 |
19,769 |
$0.00 |
| 1158F |
|
1,885 |
1,452 |
$0.00 |
| 3078F |
|
16,138 |
14,011 |
$0.00 |
| 90461 |
|
331 |
298 |
$0.00 |
| 90734 |
|
25 |
25 |
$0.00 |
| 3288F |
|
542 |
154 |
$0.00 |
| 99442 |
|
252 |
244 |
$0.00 |
| 3077F |
|
115 |
102 |
$0.00 |
| 96160 |
|
94 |
68 |
$0.00 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
93 |
57 |
$0.00 |
| 71046 |
Radiologic examination, chest; 2 views |
15 |
15 |
$0.00 |
| 2014F |
|
27 |
27 |
$0.00 |
| 3725F |
|
28 |
28 |
$0.00 |
| 90633 |
|
103 |
98 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
14 |
12 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
19 |
18 |
$0.00 |
| G0438 |
Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit |
12 |
12 |
$0.00 |
| 90674 |
|
475 |
267 |
$0.00 |
| 3074F |
|
19,232 |
16,786 |
$0.00 |
| 3079F |
|
6,865 |
5,966 |
$0.00 |
| 3008F |
|
28,231 |
23,620 |
$0.00 |
| 1126F |
|
12,154 |
10,674 |
$0.00 |
| 3075F |
|
3,067 |
2,644 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
391 |
264 |
$0.00 |
| 2010F |
|
584 |
172 |
$0.00 |
| 1170F |
|
2,186 |
1,590 |
$0.00 |
| 1125F |
|
1,191 |
1,028 |
$0.00 |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
111 |
99 |
$0.00 |
| 90651 |
|
73 |
72 |
$0.00 |
| G8419 |
Bmi documented outside normal parameters, no follow-up plan documented, no reason given |
406 |
95 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
871 |
808 |
$0.00 |
| 1220F |
|
1,718 |
1,648 |
$0.00 |
| 98967 |
|
409 |
390 |
$0.00 |
| 93000 |
|
97 |
94 |
$0.00 |
| 1157F |
|
37 |
36 |
$0.00 |
| 3061F |
|
202 |
181 |
$0.00 |
| 92551 |
|
743 |
686 |
$0.00 |
| 82962 |
|
474 |
394 |
$0.00 |
| 3044F |
|
209 |
186 |
$0.00 |
| G0328 |
Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous |
18 |
16 |
$0.00 |
| 1123F |
|
20 |
17 |
$0.00 |
| 99441 |
|
16 |
13 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
20 |
14 |
$0.00 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
15 |
12 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
32 |
32 |
$0.00 |