| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
210 |
208 |
$14K |
| T1015 |
Clinic visit/encounter, all-inclusive |
78 |
76 |
$13K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
169 |
165 |
$8K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
77 |
77 |
$6K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
67 |
67 |
$4K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
47 |
47 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
15 |
15 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
12 |
12 |
$460.00 |
| 99051 |
|
13 |
13 |
$376.00 |
| 99177 |
|
25 |
25 |
$26.43 |
| 96127 |
|
34 |
34 |
$18.48 |
| 96160 |
|
34 |
34 |
$16.08 |
| 90661 |
|
33 |
33 |
$0.00 |
| G9920 |
Screening performed and negative |
110 |
109 |
$0.00 |
| 90648 |
|
14 |
14 |
$0.00 |
| 90723 |
|
13 |
13 |
$0.00 |
| 90677 |
|
14 |
14 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
31 |
31 |
$0.00 |
| 3008F |
|
38 |
37 |
$0.00 |
| 96161 |
|
45 |
45 |
$0.00 |
| 92551 |
|
77 |
76 |
$0.00 |
| 90680 |
|
13 |
13 |
$0.00 |