| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
327 |
295 |
$90K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
343 |
294 |
$34K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
37 |
37 |
$11K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
32 |
32 |
$9K |
| 76801 |
|
88 |
77 |
$8K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
21 |
19 |
$6K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
14 |
14 |
$4K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$4K |
| 90715 |
|
12 |
12 |
$400.00 |
| 90680 |
|
14 |
14 |
$0.00 |
| 90656 |
|
93 |
93 |
$0.00 |
| 90697 |
|
14 |
14 |
$0.00 |
| 96127 |
|
53 |
53 |
$0.00 |
| 92551 |
|
63 |
63 |
$0.00 |
| 90677 |
|
15 |
15 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
16 |
14 |
$0.00 |
| 90480 |
|
16 |
16 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
12 |
12 |
$0.00 |
| T1013 |
Sign language or oral interpretive services, per 15 minutes |
71 |
70 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
205 |
205 |
$0.00 |
| 99173 |
|
64 |
64 |
$0.00 |
| T1015 |
Clinic visit/encounter, all-inclusive |
33 |
29 |
$0.00 |
| 90461 |
|
48 |
48 |
$0.00 |
| 99188 |
|
12 |
12 |
$0.00 |
| 90661 |
|
61 |
61 |
$0.00 |