| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
8,882 |
8,358 |
$773K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,229 |
1,157 |
$116K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,130 |
1,129 |
$115K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
766 |
744 |
$93K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
551 |
551 |
$56K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,304 |
3,265 |
$49K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
103 |
103 |
$11K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
63 |
63 |
$7K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
71 |
69 |
$4K |
| 81002 |
|
1,326 |
1,317 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
467 |
461 |
$3K |
| 90480 |
|
163 |
162 |
$2K |
| 0072A |
|
50 |
50 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
105 |
61 |
$2K |
| 0111A |
|
41 |
41 |
$2K |
| 0071A |
|
36 |
36 |
$1K |
| 0112A |
|
35 |
35 |
$1K |
| 0004A |
|
24 |
24 |
$917.84 |
| 85018 |
|
327 |
326 |
$677.78 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
48 |
48 |
$629.43 |
| 0144A |
|
13 |
13 |
$489.92 |
| 83655 |
|
41 |
41 |
$478.94 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
21 |
21 |
$465.09 |
| G2211 |
Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) |
17 |
17 |
$254.24 |
| 90671 |
|
62 |
61 |
$226.93 |
| 90619 |
|
78 |
78 |
$164.39 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
99 |
99 |
$123.82 |
| 96127 |
|
13 |
13 |
$57.33 |
| 90686 |
|
743 |
741 |
$22.41 |
| 99173 |
|
60 |
60 |
$18.66 |
| 96160 |
|
12 |
12 |
$6.81 |
| 91311 |
|
125 |
105 |
$0.14 |
| 91322 |
|
34 |
34 |
$0.04 |
| 90656 |
|
135 |
135 |
$0.02 |
| 91307 |
|
105 |
96 |
$0.02 |
| 90715 |
|
12 |
12 |
$0.01 |
| 91305 |
|
21 |
21 |
$0.01 |
| 90710 |
|
12 |
12 |
$0.00 |
| 90670 |
|
40 |
40 |
$0.00 |
| 91321 |
|
65 |
64 |
$0.00 |
| 99177 |
|
15 |
15 |
$0.00 |
| 90734 |
|
12 |
12 |
$0.00 |
| 90674 |
|
48 |
48 |
$0.00 |
| 90680 |
|
25 |
25 |
$0.00 |
| 90696 |
|
12 |
12 |
$0.00 |
| 90697 |
|
12 |
12 |
$0.00 |
| 90677 |
|
15 |
15 |
$0.00 |
| 99174 |
|
13 |
13 |
$0.00 |