| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,454 |
1,320 |
$67K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,560 |
1,424 |
$53K |
| T1023 |
Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter |
1,014 |
986 |
$34K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,625 |
1,512 |
$33K |
| G9001 |
Coordinated care fee, initial rate |
1,531 |
1,498 |
$27K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
218 |
212 |
$20K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
259 |
256 |
$15K |
| 90461 |
|
273 |
253 |
$8K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
638 |
608 |
$6K |
| 96161 |
|
4,955 |
2,338 |
$4K |
| 90480 |
|
93 |
93 |
$4K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
343 |
239 |
$2K |
| 96127 |
|
1,749 |
920 |
$2K |
| 92551 |
|
433 |
419 |
$2K |
| 0072A |
|
40 |
40 |
$2K |
| 0071A |
|
39 |
39 |
$2K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
228 |
201 |
$2K |
| D0145 |
Oral evaluation for a patient under three years of age |
41 |
38 |
$1K |
| 99177 |
|
195 |
190 |
$1K |
| 0124A |
|
18 |
18 |
$720.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
17 |
12 |
$684.90 |
| 92583 |
|
14 |
12 |
$487.08 |
| 0004A |
|
12 |
12 |
$480.00 |
| 99188 |
|
39 |
38 |
$464.16 |
| 99173 |
|
368 |
358 |
$147.43 |
| 90688 |
|
146 |
145 |
$121.10 |
| 0154A |
|
19 |
19 |
$120.00 |
| 0073A |
|
22 |
17 |
$120.00 |
| 85013 |
|
42 |
38 |
$101.11 |
| 96160 |
|
371 |
299 |
$47.83 |
| 91307 |
|
126 |
116 |
$1.17 |
| 91308 |
|
19 |
17 |
$0.18 |
| 91312 |
|
18 |
18 |
$0.18 |
| 91300 |
|
12 |
12 |
$0.12 |
| 91315 |
|
19 |
19 |
$0.03 |
| 90655 |
|
47 |
47 |
$0.01 |
| 99000 |
|
310 |
269 |
$0.00 |
| 90686 |
|
1,009 |
1,001 |
$0.00 |
| 36416 |
|
52 |
50 |
$0.00 |
| 90656 |
|
74 |
74 |
$0.00 |
| 99024 |
|
23 |
23 |
$0.00 |
| 91319 |
|
13 |
13 |
$0.00 |
| 99072 |
|
727 |
596 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
26 |
25 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
46 |
38 |
$0.00 |