| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,353 |
2,177 |
$142K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,470 |
1,390 |
$69K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,452 |
1,403 |
$8K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
147 |
143 |
$8K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
47 |
47 |
$5K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
169 |
167 |
$5K |
| 91320 |
|
56 |
56 |
$4K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
86 |
85 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
185 |
185 |
$2K |
| 90677 |
|
76 |
75 |
$2K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
516 |
500 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
52 |
52 |
$2K |
| 90686 |
|
528 |
512 |
$1K |
| 95115 |
|
162 |
87 |
$947.85 |
| 90480 |
|
91 |
90 |
$893.80 |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
24 |
24 |
$778.91 |
| 90656 |
|
92 |
92 |
$727.33 |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
12 |
12 |
$623.79 |
| 0071A |
|
22 |
14 |
$577.44 |
| 92015 |
Determination of refractive state |
155 |
132 |
$485.84 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
115 |
71 |
$330.72 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
16 |
12 |
$227.34 |
| 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) |
118 |
113 |
$112.54 |
| 90474 |
|
53 |
53 |
$41.44 |
| 90723 |
|
69 |
68 |
$0.00 |
| 90680 |
|
41 |
41 |
$0.00 |
| 91307 |
|
18 |
15 |
$0.00 |
| 90670 |
|
73 |
72 |
$0.00 |
| 92134 |
|
94 |
54 |
$0.00 |
| 90648 |
|
132 |
131 |
$0.00 |
| 90672 |
|
12 |
12 |
$0.00 |
| 99177 |
|
13 |
13 |
$0.00 |