| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
20,795 |
18,636 |
$1.02M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
10,284 |
9,324 |
$740K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,882 |
1,877 |
$167K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,228 |
1,205 |
$127K |
| X5622 |
|
1,694 |
1,666 |
$119K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
3,724 |
3,648 |
$77K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
4,986 |
4,869 |
$61K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,175 |
2,157 |
$56K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
942 |
900 |
$56K |
| 92015 |
Determination of refractive state |
3,976 |
3,928 |
$53K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
410 |
386 |
$41K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,320 |
1,266 |
$38K |
| 99215 |
Prolong outpt/office vis |
208 |
199 |
$28K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
336 |
329 |
$24K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,752 |
1,708 |
$23K |
| 90834 |
Psychotherapy, 45 minutes with patient |
277 |
171 |
$21K |
| 99309 |
Subsequent nursing facility care, per day, low to moderate complexity |
403 |
266 |
$17K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
201 |
195 |
$14K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
316 |
298 |
$13K |
| V2020 |
Frames, purchases |
384 |
382 |
$13K |
| 96127 |
|
1,166 |
1,108 |
$13K |
| 92341 |
|
268 |
267 |
$8K |
| 90686 |
|
1,073 |
1,063 |
$7K |
| 99442 |
|
156 |
118 |
$7K |
| 96132 |
|
42 |
42 |
$5K |
| 96130 |
|
45 |
44 |
$5K |
| 90670 |
|
200 |
192 |
$2K |
| 96138 |
|
72 |
70 |
$2K |
| 92551 |
|
898 |
869 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
49 |
48 |
$2K |
| 90682 |
|
30 |
29 |
$2K |
| 99239 |
Hospital discharge day management, more than 30 minutes |
25 |
25 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
13 |
13 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
36 |
25 |
$1K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
28 |
14 |
$1K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
13 |
13 |
$1K |
| S0281 |
Medical home program, comprehensive care coordination and planning, maintenance of plan |
117 |
115 |
$1K |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
59 |
55 |
$861.51 |
| 99188 |
|
978 |
950 |
$754.49 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
59 |
46 |
$558.32 |
| 99173 |
|
930 |
896 |
$536.18 |
| 0001A |
|
15 |
15 |
$500.31 |
| 0002A |
|
12 |
12 |
$488.76 |
| 90715 |
|
28 |
28 |
$395.07 |
| 99308 |
Subsequent nursing facility care, per day, straightforward |
75 |
65 |
$331.14 |
| 90656 |
|
41 |
40 |
$274.86 |
| 90688 |
|
13 |
13 |
$76.96 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
28 |
25 |
$58.11 |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
13 |
13 |
$11.17 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
316 |
291 |
$6.76 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
13 |
13 |
$6.00 |
| 90723 |
|
15 |
15 |
$0.00 |
| 90647 |
|
12 |
12 |
$0.00 |
| 90651 |
|
28 |
28 |
$0.00 |
| 90685 |
|
60 |
60 |
$0.00 |
| 90633 |
|
108 |
102 |
$0.00 |
| 90734 |
|
22 |
22 |
$0.00 |