| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,662 |
1,435 |
$143K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,176 |
1,087 |
$73K |
| 92567 |
|
2,363 |
2,059 |
$21K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
786 |
736 |
$7K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
452 |
440 |
$6K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
69 |
69 |
$5K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
55 |
52 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
39 |
39 |
$3K |
| 92551 |
|
244 |
244 |
$2K |
| 97804 |
|
277 |
274 |
$514.00 |
| 81002 |
|
179 |
178 |
$256.12 |
| S9451 |
Exercise classes, non-physician provider, per session |
289 |
287 |
$10.00 |
| S9470 |
Nutritional counseling, dietitian visit |
276 |
274 |
$10.00 |
| G9001 |
Coordinated care fee, initial rate |
80 |
79 |
$0.42 |
| G9002 |
Coordinated care fee, maintenance rate |
46 |
46 |
$0.20 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
17 |
17 |
$0.10 |
| 3074F |
|
231 |
228 |
$0.00 |
| 90688 |
|
19 |
19 |
$0.00 |
| 99173 |
|
48 |
48 |
$0.00 |
| 3078F |
|
229 |
227 |
$0.00 |
| 99072 |
|
28 |
23 |
$0.00 |
| 90461 |
|
14 |
14 |
$0.00 |