| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,435 |
4,647 |
$305K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,524 |
2,172 |
$197K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,850 |
1,734 |
$189K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,977 |
1,525 |
$174K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
5,146 |
4,580 |
$49K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
436 |
406 |
$45K |
| 92552 |
|
1,472 |
1,390 |
$15K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,363 |
1,293 |
$14K |
| 99188 |
|
587 |
529 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
25 |
25 |
$3K |
| 90461 |
|
585 |
480 |
$3K |
| 97802 |
|
292 |
280 |
$2K |
| 90670 |
|
950 |
841 |
$690.00 |
| 90686 |
|
1,461 |
1,238 |
$678.17 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
580 |
505 |
$544.00 |
| 90710 |
|
94 |
84 |
$430.76 |
| 90744 |
|
208 |
163 |
$236.59 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
14 |
14 |
$220.05 |
| 90474 |
|
26 |
26 |
$100.00 |
| 90633 |
|
360 |
340 |
$40.00 |
| 90674 |
|
19 |
18 |
$20.00 |
| 90698 |
|
526 |
434 |
$12.00 |
| 90620 |
|
14 |
12 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
60 |
41 |
$0.00 |
| 96127 |
|
83 |
61 |
$0.00 |
| 90677 |
|
62 |
56 |
$0.00 |
| 99173 |
|
1,815 |
1,538 |
$0.00 |
| 90681 |
|
42 |
41 |
$0.00 |
| 90700 |
|
12 |
12 |
$0.00 |