| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,426 |
1,348 |
$15K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
288 |
286 |
$13K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
524 |
518 |
$10K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
560 |
522 |
$9K |
| 92551 |
|
907 |
906 |
$7K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
355 |
349 |
$4K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
210 |
210 |
$4K |
| 99381 |
|
39 |
34 |
$3K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
259 |
253 |
$2K |
| 90670 |
|
431 |
430 |
$2K |
| 90698 |
|
418 |
418 |
$2K |
| 90686 |
|
455 |
454 |
$1K |
| 90680 |
|
186 |
186 |
$887.94 |
| 90744 |
|
145 |
145 |
$633.70 |
| 90633 |
|
204 |
203 |
$529.92 |
| 90651 |
|
78 |
78 |
$424.04 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
230 |
230 |
$373.83 |
| 90685 |
|
105 |
105 |
$341.37 |
| 96127 |
|
38 |
37 |
$161.84 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
121 |
121 |
$130.46 |
| 90710 |
|
105 |
105 |
$126.00 |
| 90734 |
|
52 |
52 |
$125.64 |
| 90707 |
|
12 |
12 |
$108.00 |
| 90696 |
|
67 |
67 |
$98.73 |
| 99173 |
|
128 |
128 |
$24.78 |
| 90715 |
|
13 |
13 |
$17.91 |
| 81002 |
|
38 |
38 |
$2.13 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
37 |
37 |
$0.00 |
| 94760 |
|
12 |
12 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
84 |
84 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
31 |
31 |
$0.00 |
| 90658 |
|
17 |
17 |
$0.00 |