| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,255 |
1,224 |
$72K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,708 |
1,636 |
$63K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
158 |
158 |
$16K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
126 |
126 |
$11K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
122 |
121 |
$9K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
77 |
77 |
$4K |
| 99051 |
|
117 |
108 |
$3K |
| 90686 |
|
337 |
330 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
66 |
61 |
$2K |
| 90670 |
|
83 |
83 |
$902.00 |
| 92551 |
|
659 |
655 |
$558.29 |
| 90647 |
|
47 |
47 |
$517.00 |
| 90723 |
|
44 |
44 |
$484.00 |
| 90656 |
|
73 |
72 |
$323.72 |
| 96127 |
|
167 |
162 |
$200.56 |
| 99173 |
|
580 |
576 |
$185.20 |
| 90681 |
|
13 |
13 |
$143.00 |
| 96160 |
|
141 |
138 |
$124.80 |
| 96161 |
|
94 |
93 |
$87.74 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
66 |
66 |
$7.69 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
127 |
127 |
$0.00 |
| 90677 |
|
13 |
13 |
$0.00 |
| 83655 |
|
27 |
27 |
$0.00 |
| G9920 |
Screening performed and negative |
225 |
225 |
$0.00 |
| 99499 |
|
35 |
35 |
$0.00 |