| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,202 |
1,983 |
$229K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,421 |
2,257 |
$161K |
| 99215 |
Prolong outpt/office vis |
494 |
478 |
$72K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
715 |
696 |
$60K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
611 |
594 |
$58K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
524 |
517 |
$52K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
768 |
708 |
$39K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
670 |
589 |
$12K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
122 |
103 |
$11K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
84 |
83 |
$8K |
| 90686 |
|
373 |
371 |
$5K |
| 90670 |
|
336 |
327 |
$4K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,025 |
1,991 |
$3K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,248 |
1,232 |
$2K |
| 99177 |
|
501 |
499 |
$1K |
| 99401 |
|
69 |
67 |
$1K |
| 90651 |
|
50 |
50 |
$984.50 |
| 90648 |
|
70 |
69 |
$766.27 |
| 90688 |
|
58 |
57 |
$587.67 |
| 90633 |
|
40 |
40 |
$496.48 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
29 |
25 |
$321.48 |
| 90700 |
|
14 |
13 |
$255.97 |
| 90677 |
|
14 |
13 |
$255.97 |
| 90710 |
|
12 |
12 |
$236.28 |
| 94760 |
|
157 |
153 |
$165.39 |
| 81002 |
|
41 |
37 |
$119.58 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
14 |
14 |
$76.92 |
| 92015 |
Determination of refractive state |
26 |
26 |
$55.05 |
| 99417 |
Prolong home eval add 15m |
166 |
156 |
$8.00 |
| 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) |
194 |
188 |
$0.00 |
| 99484 |
|
110 |
110 |
$0.00 |