| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,356 |
3,008 |
$299K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
3,083 |
2,785 |
$274K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,146 |
3,762 |
$253K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,274 |
2,134 |
$217K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
3,395 |
3,004 |
$122K |
| 99199 |
Unlisted special service, procedure or report |
33,468 |
31,712 |
$107K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
4,933 |
4,412 |
$91K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
569 |
538 |
$55K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
5,117 |
4,434 |
$42K |
| D0145 |
Oral evaluation for a patient under three years of age |
354 |
320 |
$12K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
99 |
97 |
$11K |
| 92551 |
|
2,837 |
2,570 |
$8K |
| D1206 |
Topical application of fluoride varnish |
625 |
572 |
$8K |
| 96127 |
|
1,550 |
1,309 |
$7K |
| 99381 |
|
68 |
64 |
$7K |
| 90474 |
|
200 |
151 |
$3K |
| 99173 |
|
2,051 |
1,829 |
$959.79 |
| 96161 |
|
235 |
231 |
$845.24 |
| 99442 |
|
16 |
13 |
$720.61 |
| 90686 |
|
1,379 |
1,274 |
$398.30 |
| 90633 |
|
249 |
242 |
$0.00 |
| 90670 |
|
1,163 |
1,001 |
$0.00 |
| 90681 |
|
42 |
42 |
$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 |
| 90723 |
|
968 |
871 |
$0.00 |
| 90647 |
|
1,011 |
890 |
$0.00 |
| 90680 |
|
534 |
464 |
$0.00 |
| 90656 |
|
80 |
80 |
$0.00 |