| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
6,265 |
5,716 |
$552K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,115 |
5,342 |
$431K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
703 |
617 |
$63K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
146 |
143 |
$14K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
608 |
577 |
$6K |
| 90837 |
Psychotherapy, 53 minutes with patient |
70 |
36 |
$5K |
| 81003 |
|
2,381 |
1,904 |
$5K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
456 |
370 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
33 |
33 |
$4K |
| 90670 |
|
211 |
193 |
$4K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
37 |
36 |
$4K |
| 99215 |
Prolong outpt/office vis |
27 |
27 |
$3K |
| D1206 |
Topical application of fluoride varnish |
110 |
110 |
$3K |
| 90682 |
|
28 |
27 |
$2K |
| 90686 |
|
84 |
75 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
13 |
13 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
54 |
45 |
$1K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
61 |
55 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
16 |
16 |
$908.48 |
| 90647 |
|
37 |
36 |
$721.68 |
| 0011A |
|
20 |
20 |
$720.00 |
| 0012A |
|
17 |
17 |
$640.00 |
| 90723 |
|
37 |
36 |
$582.00 |
| 99051 |
|
28 |
28 |
$385.02 |
| 81025 |
|
38 |
38 |
$274.19 |
| 90734 |
|
12 |
12 |
$256.08 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
14 |
14 |
$210.36 |
| 3008F |
|
2,777 |
2,311 |
$11.87 |
| 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) |
15 |
15 |
$8.80 |
| 1036F |
|
1,238 |
1,098 |
$7.74 |
| 3074F |
|
2,132 |
1,806 |
$5.87 |
| 1159F |
|
1,811 |
1,585 |
$5.63 |
| 1160F |
|
1,812 |
1,586 |
$5.62 |
| 3078F |
|
1,803 |
1,553 |
$5.31 |
| 3079F |
|
363 |
306 |
$0.82 |
| 3075F |
|
12 |
12 |
$0.11 |
| 99072 |
|
28 |
28 |
$0.00 |
| 3725F |
|
54 |
50 |
$0.00 |