| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,604 |
3,119 |
$260K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,813 |
2,398 |
$123K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
881 |
773 |
$54K |
| S0281 |
Medical home program, comprehensive care coordination and planning, maintenance of plan |
1,343 |
1,008 |
$19K |
| 99215 |
Prolong outpt/office vis |
132 |
126 |
$17K |
| G0438 |
Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit |
83 |
77 |
$11K |
| S0280 |
Medical home program, comprehensive care coordination and planning, initial plan |
852 |
672 |
$11K |
| 36410 |
|
1,026 |
925 |
$10K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
60 |
58 |
$5K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
49 |
39 |
$5K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
98 |
87 |
$4K |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
16 |
15 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
16 |
16 |
$1K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
37 |
33 |
$1K |
| 99441 |
|
30 |
29 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
67 |
61 |
$885.98 |
| 99442 |
|
13 |
13 |
$833.26 |
| 90715 |
|
15 |
14 |
$506.16 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
15 |
14 |
$235.91 |