| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
9,459 |
7,503 |
$2.10M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,998 |
2,610 |
$582K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,209 |
1,129 |
$282K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
874 |
831 |
$187K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
442 |
390 |
$90K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
255 |
248 |
$55K |
| D0999 |
Unspecified diagnostic procedure, by report |
80 |
60 |
$27K |
| 90837 |
Psychotherapy, 53 minutes with patient |
134 |
83 |
$20K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
25 |
25 |
$6K |
| 99000 |
|
3,160 |
2,847 |
$3K |
| 0072A |
|
28 |
28 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,479 |
2,368 |
$1K |
| 0002A |
|
45 |
28 |
$1K |
| D1206 |
Topical application of fluoride varnish |
46 |
34 |
$1K |
| 0071A |
|
44 |
26 |
$1K |
| 0001A |
|
35 |
24 |
$988.32 |
| 90686 |
|
597 |
581 |
$795.81 |
| 90670 |
|
997 |
973 |
$484.00 |
| D1120 |
Prophylaxis - child |
16 |
15 |
$483.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
2,442 |
1,524 |
$460.66 |
| 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 |
42 |
27 |
$426.81 |
| 36415 |
Collection of venous blood by venipuncture |
1,719 |
1,580 |
$244.80 |
| 90633 |
|
53 |
52 |
$105.00 |
| 90698 |
|
178 |
176 |
$93.00 |
| 90700 |
|
13 |
12 |
$75.16 |
| 90474 |
|
315 |
295 |
$22.38 |
| D9996 |
|
29 |
26 |
$0.15 |
| 90680 |
|
561 |
542 |
$0.10 |
| 90647 |
|
250 |
232 |
$0.00 |
| 85018 |
|
518 |
494 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
787 |
750 |
$0.00 |
| 90688 |
|
100 |
100 |
$0.00 |
| 96127 |
|
76 |
71 |
$0.00 |
| 90723 |
|
103 |
86 |
$0.00 |
| 90744 |
|
16 |
16 |
$0.00 |
| 91307 |
|
20 |
18 |
$0.00 |
| 90651 |
|
13 |
13 |
$0.00 |
| 90685 |
|
78 |
78 |
$0.00 |
| D0350 |
|
23 |
21 |
$0.00 |
| 81002 |
|
1,226 |
805 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
103 |
102 |
$0.00 |
| 99173 |
|
111 |
103 |
$0.00 |
| 81003 |
|
195 |
176 |
$0.00 |
| T1015 |
Clinic visit/encounter, all-inclusive |
434 |
218 |
$0.00 |
| 83655 |
|
105 |
102 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
114 |
112 |
$0.00 |
| 81025 |
|
67 |
63 |
$0.00 |
| 90473 |
|
45 |
45 |
$0.00 |
| 90710 |
|
28 |
28 |
$0.00 |
| 90648 |
|
29 |
29 |
$0.00 |