| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,352 |
3,221 |
$270K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,718 |
4,449 |
$270K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
435 |
428 |
$36K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,027 |
2,002 |
$32K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
381 |
377 |
$31K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
284 |
282 |
$23K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
2,327 |
2,268 |
$22K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
461 |
456 |
$8K |
| D0190 |
|
439 |
428 |
$6K |
| 81002 |
|
1,541 |
1,523 |
$4K |
| 96127 |
|
1,081 |
1,067 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
38 |
38 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
197 |
195 |
$2K |
| 90686 |
|
539 |
538 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
67 |
63 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
102 |
102 |
$957.20 |
| 92558 |
|
177 |
170 |
$842.53 |
| 98966 |
|
116 |
113 |
$423.23 |
| 90688 |
|
30 |
30 |
$412.10 |
| 90656 |
|
60 |
60 |
$290.55 |
| 99188 |
|
38 |
37 |
$261.93 |
| 90672 |
|
17 |
17 |
$26.88 |
| G9002 |
Coordinated care fee, maintenance rate |
756 |
540 |
$1.31 |
| G9007 |
Coordinated care fee, scheduled team conference |
935 |
671 |
$1.20 |
| 3078F |
|
2,595 |
2,516 |
$0.15 |
| 3074F |
|
2,695 |
2,616 |
$0.13 |
| 3079F |
|
191 |
190 |
$0.05 |
| 3075F |
|
64 |
62 |
$0.03 |
| 1160F |
|
648 |
637 |
$0.00 |
| 1159F |
|
649 |
638 |
$0.00 |
| 90670 |
|
24 |
24 |
$0.00 |
| 99177 |
|
119 |
115 |
$0.00 |