| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,295 |
3,044 |
$240K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,360 |
894 |
$98K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
720 |
419 |
$1K |
| Q3014 |
Telehealth originating site facility fee |
225 |
159 |
$1K |
| X5622 |
|
26 |
13 |
$446.70 |
| 90686 |
|
435 |
258 |
$414.77 |
| 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) |
47 |
29 |
$24.62 |
| 96127 |
|
27 |
12 |
$4.56 |
| 99173 |
|
28 |
12 |
$1.82 |
| 91300 |
|
76 |
70 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
32 |
13 |
$0.00 |
| 90656 |
|
16 |
13 |
$0.00 |