| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,421 |
1,365 |
$64K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
16,905 |
15,082 |
$61K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
13,721 |
13,156 |
$40K |
| 99381 |
|
132 |
125 |
$10K |
| 90686 |
|
596 |
596 |
$10K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,071 |
1,054 |
$9K |
| 0012A |
|
217 |
217 |
$8K |
| 59425 |
|
594 |
433 |
$7K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
736 |
732 |
$7K |
| 0011A |
|
169 |
169 |
$7K |
| 90715 |
|
138 |
120 |
$5K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,044 |
1,035 |
$4K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
706 |
699 |
$4K |
| 92551 |
|
3,329 |
3,310 |
$3K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
143 |
143 |
$2K |
| 90670 |
|
221 |
220 |
$2K |
| 81002 |
|
5,527 |
4,571 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
940 |
901 |
$2K |
| 90723 |
|
153 |
152 |
$1K |
| 90656 |
|
48 |
48 |
$1K |
| 90647 |
|
111 |
111 |
$970.14 |
| 0001A |
|
21 |
21 |
$840.00 |
| G9920 |
Screening performed and negative |
25 |
25 |
$725.00 |
| 99460 |
|
36 |
36 |
$497.06 |
| 90681 |
|
60 |
59 |
$448.55 |
| 90648 |
|
58 |
57 |
$436.41 |
| 96127 |
|
506 |
501 |
$393.79 |
| 99173 |
|
3,994 |
3,955 |
$323.46 |
| 99215 |
Prolong outpt/office vis |
87 |
86 |
$254.57 |
| 90680 |
|
30 |
30 |
$252.00 |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
12 |
12 |
$175.62 |
| 85018 |
|
1,576 |
1,568 |
$168.61 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
28 |
27 |
$157.61 |
| 86580 |
|
515 |
501 |
$118.86 |
| 90677 |
|
13 |
13 |
$117.00 |
| 99462 |
|
15 |
12 |
$108.88 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
248 |
239 |
$101.56 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
449 |
431 |
$94.50 |
| 81025 |
|
256 |
253 |
$61.55 |
| 90662 |
|
13 |
13 |
$45.29 |
| 93000 |
|
78 |
75 |
$42.61 |
| 99188 |
|
49 |
49 |
$17.82 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
33 |
33 |
$7.69 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,805 |
1,792 |
$4.42 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
235 |
219 |
$0.44 |
| 36416 |
|
1,349 |
1,340 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
58 |
58 |
$0.00 |
| 99385 |
|
101 |
98 |
$0.00 |
| 1126F |
|
12 |
12 |
$0.00 |
| G9008 |
Coordinated care fee, physician coordinated care oversight services |
53 |
47 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
495 |
493 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,720 |
1,681 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
355 |
353 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
24 |
24 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
12 |
12 |
$0.00 |