| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,670 |
1,479 |
$88K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
609 |
551 |
$41K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
588 |
553 |
$22K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
328 |
323 |
$20K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
226 |
223 |
$15K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
445 |
436 |
$6K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
78 |
74 |
$5K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
41 |
39 |
$4K |
| 90756 |
|
241 |
236 |
$4K |
| 99401 |
|
176 |
169 |
$4K |
| 99442 |
|
61 |
59 |
$3K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
81 |
80 |
$2K |
| S9452 |
Nutrition classes, non-physician provider, per session |
259 |
255 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
234 |
228 |
$1K |
| 90461 |
|
48 |
44 |
$1K |
| 99384 |
|
17 |
17 |
$1K |
| 99383 |
|
21 |
14 |
$785.92 |
| 99382 |
|
15 |
14 |
$634.16 |
| 92551 |
|
52 |
48 |
$385.36 |
| 98960 |
|
128 |
128 |
$323.75 |
| T1013 |
Sign language or oral interpretive services, per 15 minutes |
15 |
15 |
$122.72 |
| 99051 |
|
142 |
126 |
$84.00 |
| V5008 |
Hearing screening |
534 |
531 |
$25.00 |
| 90658 |
|
36 |
36 |
$11.37 |
| 99173 |
|
379 |
377 |
$9.26 |
| 1125F |
|
21 |
20 |
$0.00 |
| 94760 |
|
68 |
60 |
$0.00 |
| 90686 |
|
71 |
71 |
$0.00 |
| 2010F |
|
393 |
352 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
16 |
16 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
113 |
113 |
$0.00 |
| 1126F |
|
219 |
177 |
$0.00 |
| 3725F |
|
115 |
115 |
$0.00 |
| 90734 |
|
13 |
12 |
$0.00 |
| 90633 |
|
12 |
12 |
$0.00 |