| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,257 |
4,051 |
$262K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
830 |
828 |
$63K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
573 |
571 |
$38K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
409 |
400 |
$36K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,223 |
1,209 |
$24K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
228 |
228 |
$18K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
131 |
131 |
$10K |
| 87428 |
|
289 |
287 |
$8K |
| 99000 |
|
651 |
624 |
$6K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
383 |
383 |
$5K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
589 |
589 |
$4K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
287 |
284 |
$4K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
110 |
109 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
257 |
236 |
$3K |
| 96127 |
|
437 |
381 |
$1K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
62 |
61 |
$1K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
155 |
154 |
$994.37 |
| 83655 |
|
82 |
82 |
$820.26 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
26 |
26 |
$803.82 |
| 99177 |
|
396 |
396 |
$618.40 |
| 0071A |
|
14 |
14 |
$529.90 |
| 99051 |
|
85 |
84 |
$447.40 |
| 36416 |
|
99 |
99 |
$250.00 |
| 90473 |
|
65 |
65 |
$194.37 |
| 2000F |
|
230 |
223 |
$1.38 |
| 3008F |
|
14 |
14 |
$0.12 |
| 90686 |
|
626 |
624 |
$0.08 |
| G9002 |
Coordinated care fee, maintenance rate |
17 |
15 |
$0.05 |
| 3078F |
|
243 |
235 |
$0.00 |
| 90670 |
|
547 |
546 |
$0.00 |
| 90633 |
|
58 |
58 |
$0.00 |
| G9920 |
Screening performed and negative |
35 |
35 |
$0.00 |
| 91300 |
|
13 |
13 |
$0.00 |
| 90461 |
|
14 |
14 |
$0.00 |
| 99072 |
|
216 |
212 |
$0.00 |
| 90680 |
|
205 |
205 |
$0.00 |
| 90698 |
|
400 |
399 |
$0.00 |
| 3074F |
|
243 |
235 |
$0.00 |
| 96161 |
|
12 |
12 |
$0.00 |
| Q3014 |
Telehealth originating site facility fee |
29 |
28 |
$0.00 |
| 90744 |
|
69 |
69 |
$0.00 |
| 90697 |
|
55 |
55 |
$0.00 |
| 91307 |
|
36 |
36 |
$0.00 |