| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,880 |
1,821 |
$51K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
8,933 |
8,194 |
$47K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
9,452 |
8,808 |
$31K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,316 |
2,278 |
$11K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,504 |
1,498 |
$8K |
| 97803 |
|
4,291 |
4,245 |
$7K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
711 |
709 |
$4K |
| 90697 |
|
126 |
125 |
$3K |
| 92551 |
|
1,354 |
1,348 |
$3K |
| 90680 |
|
693 |
685 |
$3K |
| 99460 |
|
53 |
53 |
$3K |
| 90677 |
|
255 |
254 |
$2K |
| G9920 |
Screening performed and negative |
791 |
784 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
5,862 |
5,761 |
$2K |
| 90698 |
|
731 |
727 |
$1K |
| 90670 |
|
935 |
931 |
$1K |
| 90461 |
|
2,921 |
2,862 |
$1K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
28 |
28 |
$1K |
| 99462 |
|
38 |
24 |
$923.19 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
1,037 |
1,035 |
$898.62 |
| 90651 |
|
157 |
156 |
$888.32 |
| S9451 |
Exercise classes, non-physician provider, per session |
3,444 |
3,428 |
$721.58 |
| 0071A |
|
21 |
19 |
$720.00 |
| 3008F |
|
3,431 |
3,416 |
$680.00 |
| 90744 |
|
347 |
343 |
$662.89 |
| 0072A |
|
16 |
16 |
$640.00 |
| 90686 |
|
864 |
861 |
$606.84 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
364 |
356 |
$536.90 |
| 90681 |
|
24 |
24 |
$305.00 |
| 99173 |
|
2,910 |
2,902 |
$229.50 |
| 90671 |
|
189 |
189 |
$189.00 |
| 90633 |
|
527 |
527 |
$168.00 |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
44 |
44 |
$131.65 |
| 90688 |
|
68 |
68 |
$107.04 |
| 90707 |
|
237 |
237 |
$81.00 |
| 90716 |
|
227 |
227 |
$72.00 |
| 90710 |
|
133 |
133 |
$63.00 |
| 90656 |
|
80 |
79 |
$60.00 |
| 90685 |
|
20 |
18 |
$55.66 |
| 90648 |
|
25 |
24 |
$27.00 |
| 90700 |
|
55 |
54 |
$18.00 |
| 90715 |
|
55 |
55 |
$18.00 |
| 90696 |
|
39 |
39 |
$18.00 |
| 90619 |
|
56 |
56 |
$18.00 |
| 90734 |
|
29 |
29 |
$9.00 |
| 99215 |
Prolong outpt/office vis |
19 |
17 |
$0.00 |
| 99401 |
|
63 |
63 |
$0.00 |
| 1220F |
|
84 |
83 |
$0.00 |