| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
7,818 |
6,055 |
$480K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,085 |
2,618 |
$106K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,017 |
929 |
$58K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,850 |
2,482 |
$31K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
344 |
301 |
$19K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
332 |
303 |
$18K |
| 92551 |
|
2,784 |
2,415 |
$17K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,171 |
1,069 |
$16K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
108 |
89 |
$9K |
| 99215 |
Prolong outpt/office vis |
94 |
81 |
$6K |
| 81002 |
|
2,590 |
2,293 |
$4K |
| 99173 |
|
2,801 |
2,448 |
$4K |
| 85018 |
|
506 |
414 |
$768.65 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
133 |
115 |
$710.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
12 |
12 |
$238.32 |
| 83655 |
|
213 |
174 |
$149.93 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
16 |
15 |
$88.92 |
| 90657 |
|
67 |
39 |
$12.50 |
| 87800 |
|
263 |
235 |
$10.00 |
| 36416 |
|
72 |
57 |
$2.53 |
| 3008F |
|
250 |
195 |
$0.00 |
| 90620 |
|
436 |
382 |
$0.00 |
| 90686 |
|
98 |
94 |
$0.00 |
| 90649 |
|
243 |
224 |
$0.00 |
| 91300 |
|
118 |
66 |
$0.00 |
| 90658 |
|
186 |
170 |
$0.00 |
| 90655 |
|
40 |
39 |
$0.00 |
| G8539 |
Functional outcome assessment documented as positive using a standardized tool and a care plan based on identified deficiencies is documented within two days of the functional outcome assessment |
21 |
15 |
$0.00 |
| 90633 |
|
13 |
12 |
$0.00 |
| 90662 |
|
29 |
24 |
$0.00 |