| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
661 |
654 |
$13K |
| 97802 |
|
659 |
652 |
$7K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
525 |
488 |
$7K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
593 |
557 |
$5K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
264 |
261 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
140 |
140 |
$2K |
| 92552 |
|
264 |
261 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
62 |
62 |
$828.72 |
| 90686 |
|
125 |
121 |
$760.60 |
| 90677 |
|
129 |
128 |
$646.00 |
| 90633 |
|
116 |
113 |
$492.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
17 |
17 |
$381.49 |
| 90716 |
|
96 |
93 |
$351.00 |
| 90723 |
|
65 |
64 |
$348.00 |
| 90647 |
|
62 |
61 |
$284.00 |
| 85018 |
|
312 |
309 |
$240.87 |
| 90680 |
|
29 |
29 |
$187.00 |
| 81000 |
|
163 |
161 |
$154.47 |
| 90707 |
|
42 |
41 |
$152.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
21 |
20 |
$124.44 |
| 90700 |
|
28 |
28 |
$63.00 |
| 86580 |
|
14 |
14 |
$28.24 |
| 90651 |
|
13 |
13 |
$18.00 |
| 99173 |
|
157 |
157 |
$0.00 |
| 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) |
298 |
276 |
$0.00 |
| 99174 |
|
13 |
13 |
$0.00 |
| 99172 |
|
74 |
71 |
$0.00 |