| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,805 |
5,397 |
$326K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,689 |
1,676 |
$162K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,374 |
1,296 |
$131K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
552 |
519 |
$44K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
336 |
336 |
$35K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,287 |
2,262 |
$31K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,122 |
926 |
$30K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,955 |
1,443 |
$19K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,703 |
1,327 |
$19K |
| 99381 |
|
160 |
154 |
$15K |
| 87428 |
|
215 |
210 |
$10K |
| 90474 |
|
401 |
397 |
$4K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
252 |
244 |
$4K |
| 90461 |
|
523 |
464 |
$2K |
| 90791 |
Psychiatric diagnostic evaluation |
14 |
14 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$1K |
| 99000 |
|
102 |
99 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
12 |
12 |
$828.88 |
| 90847 |
Family psychotherapy with the patient present, 50 minutes |
14 |
12 |
$768.28 |
| 90686 |
|
1,024 |
1,016 |
$43.67 |
| 99421 |
|
13 |
13 |
$18.20 |
| 94760 |
|
56 |
54 |
$13.13 |
| 90680 |
|
680 |
647 |
$0.00 |
| 90698 |
|
279 |
276 |
$0.00 |
| 90716 |
|
121 |
121 |
$0.00 |
| 90677 |
|
283 |
282 |
$0.00 |
| 90697 |
|
607 |
577 |
$0.00 |
| 90656 |
|
179 |
179 |
$0.00 |
| S3620 |
Newborn metabolic screening panel, includes test kit, postage and the laboratory tests specified by the state for inclusion in this panel (e.g., galactose; hemoglobin, electrophoresis; hydroxyprogesterone, 17-d; phenylalanine (pku); and thyroxine, total) |
15 |
14 |
$0.00 |
| 90707 |
|
119 |
119 |
$0.00 |
| 90633 |
|
346 |
344 |
$0.00 |
| 90670 |
|
817 |
783 |
$0.00 |
| 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) |
12 |
12 |
$0.00 |
| 91308 |
|
12 |
12 |
$0.00 |