| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,712 |
1,535 |
$101K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
770 |
724 |
$65K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
646 |
617 |
$34K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
108 |
105 |
$10K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
118 |
108 |
$9K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
583 |
570 |
$9K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
66 |
65 |
$6K |
| 92551 |
|
476 |
448 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
29 |
27 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
135 |
127 |
$2K |
| 96127 |
|
63 |
39 |
$719.02 |
| 99177 |
|
41 |
39 |
$677.04 |
| 90716 |
|
15 |
12 |
$543.06 |
| 99173 |
|
46 |
41 |
$324.06 |
| 90707 |
|
15 |
12 |
$312.99 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
20 |
14 |
$252.73 |
| 90686 |
|
214 |
205 |
$209.31 |
| 90461 |
|
250 |
242 |
$125.44 |
| 99000 |
|
310 |
272 |
$100.56 |
| 36416 |
|
111 |
95 |
$13.30 |
| 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) |
159 |
143 |
$8.75 |
| 90651 |
|
12 |
12 |
$0.00 |
| 90656 |
|
38 |
35 |
$0.00 |
| 90688 |
|
56 |
56 |
$0.00 |
| 90670 |
|
13 |
13 |
$0.00 |
| 90671 |
|
12 |
12 |
$0.00 |