| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,886 |
3,610 |
$306K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,390 |
4,025 |
$236K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,741 |
2,738 |
$197K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,177 |
2,170 |
$141K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,834 |
1,834 |
$131K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
993 |
993 |
$78K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
3,090 |
3,085 |
$41K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
5,170 |
5,150 |
$39K |
| 99381 |
|
373 |
373 |
$32K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,763 |
1,561 |
$18K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,087 |
1,066 |
$14K |
| D0190 |
|
964 |
964 |
$14K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
551 |
408 |
$11K |
| 96127 |
|
3,110 |
3,039 |
$9K |
| 83655 |
|
710 |
710 |
$8K |
| 99188 |
|
1,018 |
1,018 |
$7K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
217 |
215 |
$7K |
| 90474 |
|
1,299 |
1,299 |
$5K |
| 96161 |
|
1,089 |
1,078 |
$2K |
| 85018 |
|
223 |
221 |
$493.23 |
| 81003 |
|
270 |
252 |
$469.28 |
| 87807 |
|
16 |
15 |
$196.00 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
18 |
16 |
$188.20 |
| 96160 |
|
48 |
48 |
$75.30 |
| 98966 |
|
316 |
263 |
$0.02 |
| 90734 |
|
194 |
194 |
$0.00 |
| 90700 |
|
320 |
320 |
$0.00 |
| 90633 |
|
935 |
935 |
$0.00 |
| 90707 |
|
322 |
322 |
$0.00 |
| 90670 |
|
1,847 |
1,847 |
$0.00 |
| 90710 |
|
160 |
160 |
$0.00 |
| 90648 |
|
235 |
235 |
$0.00 |
| 90685 |
|
335 |
335 |
$0.00 |
| 90715 |
|
60 |
60 |
$0.00 |
| G9002 |
Coordinated care fee, maintenance rate |
13 |
12 |
$0.00 |
| 90680 |
|
1,309 |
1,309 |
$0.00 |
| 90716 |
|
311 |
311 |
$0.00 |
| 90698 |
|
1,387 |
1,387 |
$0.00 |
| 90744 |
|
970 |
970 |
$0.00 |
| 90651 |
|
188 |
188 |
$0.00 |
| 90686 |
|
847 |
847 |
$0.00 |
| 90696 |
|
173 |
173 |
$0.00 |