| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,334 |
2,094 |
$112K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,184 |
950 |
$86K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
890 |
791 |
$68K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
725 |
595 |
$49K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
407 |
379 |
$30K |
| 90686 |
|
1,033 |
914 |
$12K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
497 |
424 |
$9K |
| 96127 |
|
525 |
470 |
$9K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
100 |
85 |
$8K |
| 99215 |
Prolong outpt/office vis |
79 |
72 |
$6K |
| 90677 |
|
76 |
69 |
$5K |
| 90670 |
|
190 |
153 |
$4K |
| 91322 |
|
22 |
13 |
$2K |
| 90656 |
|
106 |
91 |
$2K |
| 90647 |
|
64 |
53 |
$905.32 |
| 90723 |
|
37 |
28 |
$454.99 |
| 90680 |
|
34 |
26 |
$435.79 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
37 |
35 |
$406.76 |
| 91321 |
|
17 |
14 |
$284.07 |
| 85018 |
|
89 |
75 |
$206.96 |
| 90734 |
|
12 |
12 |
$201.36 |
| 90707 |
|
14 |
12 |
$151.84 |
| 90648 |
|
15 |
12 |
$128.10 |
| 90633 |
|
17 |
13 |
$108.80 |
| 90698 |
|
15 |
14 |
$96.00 |
| 90461 |
|
12 |
12 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
21 |
21 |
$0.00 |