| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,105 |
1,750 |
$168K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
326 |
308 |
$27K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
320 |
273 |
$21K |
| 90677 |
|
209 |
202 |
$10K |
| 92552 |
|
96 |
92 |
$2K |
| 90656 |
|
103 |
103 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
24 |
24 |
$2K |
| G0467 |
Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit |
118 |
103 |
$1K |
| 90834 |
Psychotherapy, 45 minutes with patient |
12 |
12 |
$1K |
| 36415 |
Collection of venous blood by venipuncture |
639 |
574 |
$1K |
| 90697 |
|
60 |
57 |
$1K |
| 90681 |
|
37 |
36 |
$910.15 |
| 90686 |
|
53 |
50 |
$752.55 |
| 3008F |
|
290 |
261 |
$450.00 |
| 99000 |
|
969 |
856 |
$404.80 |
| 90633 |
|
27 |
27 |
$309.59 |
| 90688 |
|
12 |
12 |
$250.44 |
| 99173 |
|
107 |
102 |
$219.83 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
693 |
653 |
$145.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
12 |
12 |
$119.40 |
| 94760 |
|
2,812 |
2,391 |
$93.99 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
328 |
239 |
$74.60 |
| 96160 |
|
49 |
44 |
$36.51 |
| 90473 |
|
37 |
36 |
$0.00 |