| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99215 |
Prolong outpt/office vis |
274 |
259 |
$18K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
387 |
371 |
$17K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
126 |
120 |
$9K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
85 |
85 |
$6K |
| 92552 |
|
243 |
241 |
$6K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
175 |
170 |
$6K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
662 |
641 |
$5K |
| 99383 |
|
44 |
44 |
$3K |
| 94761 |
|
919 |
843 |
$3K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
195 |
194 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
35 |
35 |
$3K |
| 99382 |
|
45 |
45 |
$2K |
| 99384 |
|
26 |
26 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
307 |
305 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
45 |
43 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
18 |
18 |
$2K |
| Q3014 |
Telehealth originating site facility fee |
22 |
22 |
$439.95 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
18 |
18 |
$236.13 |
| 90674 |
|
86 |
85 |
$0.82 |
| 90723 |
|
29 |
29 |
$0.00 |
| 90686 |
|
13 |
13 |
$0.00 |
| 90670 |
|
81 |
81 |
$0.00 |
| 90633 |
|
24 |
24 |
$0.00 |
| 90648 |
|
37 |
37 |
$0.00 |