| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,243 |
1,030 |
$53K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
313 |
286 |
$16K |
| 99215 |
Prolong outpt/office vis |
171 |
153 |
$11K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
196 |
185 |
$11K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
640 |
520 |
$6K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
129 |
118 |
$4K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
53 |
51 |
$4K |
| 99383 |
|
45 |
44 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
30 |
26 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
13 |
13 |
$828.60 |
| 99381 |
|
13 |
12 |
$695.59 |
| 90671 |
|
16 |
16 |
$440.68 |
| 99382 |
|
13 |
13 |
$429.35 |
| 90461 |
|
314 |
263 |
$393.39 |
| 99000 |
|
30 |
29 |
$268.38 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
30 |
27 |
$142.31 |
| 90686 |
|
21 |
14 |
$17.52 |
| 90697 |
|
12 |
12 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
33 |
26 |
$0.00 |
| 90670 |
|
27 |
26 |
$0.00 |