| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,805 |
1,704 |
$68K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
806 |
761 |
$42K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
503 |
495 |
$40K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
388 |
380 |
$32K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
304 |
298 |
$27K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
332 |
326 |
$26K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,096 |
1,016 |
$17K |
| 90461 |
|
709 |
582 |
$5K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
564 |
387 |
$5K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
111 |
108 |
$3K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
97 |
93 |
$1K |
| 83655 |
|
118 |
117 |
$1K |
| 96160 |
|
318 |
304 |
$751.75 |
| 99001 |
|
155 |
150 |
$243.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
18 |
12 |
$191.90 |
| S8301 |
Infection control supplies, not otherwise specified |
155 |
150 |
$157.08 |
| 86580 |
|
13 |
13 |
$89.45 |
| 90686 |
|
242 |
241 |
$0.01 |
| 90651 |
|
112 |
111 |
$0.00 |
| 90680 |
|
157 |
157 |
$0.00 |
| 90698 |
|
287 |
287 |
$0.00 |
| 90744 |
|
114 |
113 |
$0.00 |
| 90696 |
|
21 |
21 |
$0.00 |
| 99173 |
|
576 |
563 |
$0.00 |
| 90710 |
|
159 |
159 |
$0.00 |
| 90734 |
|
107 |
105 |
$0.00 |
| 90670 |
|
287 |
287 |
$0.00 |
| 90633 |
|
155 |
155 |
$0.00 |
| 90715 |
|
52 |
52 |
$0.00 |