| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
903 |
711 |
$15K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
161 |
161 |
$12K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,071 |
833 |
$11K |
| 96156 |
|
63 |
63 |
$7K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
113 |
113 |
$5K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
72 |
72 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
39 |
39 |
$2K |
| 90686 |
|
95 |
95 |
$846.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
14 |
14 |
$616.44 |
| 90670 |
|
28 |
28 |
$252.00 |
| 90633 |
|
18 |
18 |
$162.00 |
| 90716 |
|
15 |
15 |
$135.00 |
| 90744 |
|
13 |
13 |
$117.00 |
| 90651 |
|
12 |
12 |
$108.00 |
| 92551 |
|
41 |
41 |
$94.06 |
| 99000 |
|
137 |
131 |
$79.86 |
| 94760 |
|
471 |
447 |
$22.36 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
17 |
17 |
$10.70 |
| 99174 |
|
14 |
14 |
$0.00 |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
18 |
18 |
$0.00 |
| 96127 |
|
20 |
20 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
420 |
416 |
$0.00 |
| 96160 |
|
29 |
29 |
$0.00 |
| 90461 |
|
183 |
183 |
$0.00 |
| 99173 |
|
58 |
58 |
$0.00 |
| 99072 |
|
15 |
15 |
$0.00 |