| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,507 |
1,389 |
$78K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
861 |
799 |
$56K |
| 99215 |
Prolong outpt/office vis |
459 |
434 |
$38K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
669 |
659 |
$26K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
306 |
291 |
$24K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
116 |
116 |
$8K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
39 |
38 |
$3K |
| 96127 |
|
183 |
180 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
53 |
52 |
$973.82 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
12 |
12 |
$916.60 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
33 |
33 |
$470.70 |
| 96380 |
|
13 |
12 |
$254.04 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
12 |
12 |
$65.08 |
| 90656 |
|
130 |
127 |
$22.36 |
| 90686 |
|
111 |
111 |
$19.76 |
| 90461 |
|
256 |
254 |
$0.02 |
| 90680 |
|
13 |
13 |
$0.00 |
| 90677 |
|
45 |
45 |
$0.00 |
| 90647 |
|
40 |
40 |
$0.00 |
| 90723 |
|
45 |
45 |
$0.00 |
| 90670 |
|
37 |
37 |
$0.00 |
| 90633 |
|
12 |
12 |
$0.00 |
| 90681 |
|
25 |
25 |
$0.00 |