| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,045 |
1,900 |
$37K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
293 |
286 |
$12K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
456 |
423 |
$12K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
448 |
445 |
$10K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
358 |
353 |
$7K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
304 |
292 |
$4K |
| 87428 |
|
327 |
321 |
$829.50 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
951 |
923 |
$630.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
133 |
128 |
$491.71 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
555 |
536 |
$170.00 |
| 0071A |
|
14 |
14 |
$80.00 |
| 0072A |
|
16 |
16 |
$80.00 |
| 92558 |
|
962 |
946 |
$52.72 |
| 90474 |
|
75 |
73 |
$30.00 |
| 85018 |
|
432 |
405 |
$11.35 |
| 90620 |
|
86 |
83 |
$10.00 |
| 96160 |
|
481 |
452 |
$5.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
192 |
178 |
$0.02 |
| 90633 |
|
148 |
141 |
$0.00 |
| 90734 |
|
121 |
120 |
$0.00 |
| 90681 |
|
58 |
55 |
$0.00 |
| 90670 |
|
230 |
225 |
$0.00 |
| 99173 |
|
842 |
815 |
$0.00 |
| 3046F |
|
120 |
111 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
186 |
176 |
$0.00 |
| 90710 |
|
107 |
106 |
$0.00 |
| 90700 |
|
16 |
12 |
$0.00 |
| 90715 |
|
14 |
14 |
$0.00 |
| 90651 |
|
169 |
168 |
$0.00 |
| 36416 |
|
123 |
113 |
$0.00 |
| 3074F |
|
335 |
329 |
$0.00 |
| 90723 |
|
171 |
166 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
334 |
316 |
$0.00 |
| 90686 |
|
78 |
78 |
$0.00 |
| 90647 |
|
148 |
144 |
$0.00 |
| 1036F |
|
166 |
150 |
$0.00 |
| 99000 |
|
14 |
14 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
16 |
15 |
$0.00 |
| 90696 |
|
14 |
14 |
$0.00 |