| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,064 |
1,044 |
$9K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
151 |
150 |
$7K |
| 90658 |
|
444 |
422 |
$6K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,143 |
1,094 |
$5K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
64 |
64 |
$4K |
| 90686 |
|
58 |
58 |
$847.20 |
| 92552 |
|
64 |
64 |
$734.80 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
12 |
12 |
$412.60 |
| 92081 |
|
55 |
55 |
$139.70 |
| 90734 |
|
13 |
12 |
$95.44 |
| 99441 |
|
239 |
237 |
$83.88 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
48 |
38 |
$40.16 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
585 |
537 |
$39.92 |
| 81001 |
|
40 |
40 |
$0.00 |
| G9604 |
Patient survey results not available |
164 |
164 |
$0.00 |
| 3074F |
|
108 |
104 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
29 |
29 |
$0.00 |
| 99406 |
|
12 |
12 |
$0.00 |
| 3078F |
|
175 |
171 |
$0.00 |
| 99408 |
|
12 |
12 |
$0.00 |
| 99442 |
|
15 |
14 |
$0.00 |