| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,309 |
1,248 |
$34K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
391 |
384 |
$18K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
217 |
215 |
$14K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
257 |
256 |
$12K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
131 |
131 |
$7K |
| 92551 |
|
384 |
384 |
$5K |
| 96151 |
|
248 |
246 |
$4K |
| 99460 |
|
42 |
42 |
$4K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
48 |
47 |
$3K |
| 90670 |
|
293 |
288 |
$3K |
| 96156 |
|
48 |
26 |
$3K |
| 90698 |
|
232 |
227 |
$2K |
| 90680 |
|
168 |
164 |
$2K |
| 99381 |
|
25 |
25 |
$1K |
| 90686 |
|
115 |
115 |
$1K |
| 90744 |
|
96 |
93 |
$855.00 |
| 87430 |
|
68 |
67 |
$707.66 |
| 90685 |
|
70 |
70 |
$630.00 |
| 99239 |
Hospital discharge day management, more than 30 minutes |
12 |
12 |
$483.52 |
| 96150 |
|
103 |
84 |
$454.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
139 |
134 |
$414.65 |
| 90707 |
|
43 |
41 |
$387.00 |
| 90716 |
|
26 |
26 |
$234.00 |
| 94760 |
|
26 |
26 |
$11.18 |
| 99050 |
|
356 |
351 |
$0.00 |
| E0700 |
Safety equipment, device or accessory, any type |
51 |
47 |
$0.00 |
| 99172 |
|
45 |
45 |
$0.00 |
| 99072 |
|
51 |
45 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
27 |
27 |
$0.00 |
| 99173 |
|
71 |
71 |
$0.00 |
| H1003 |
Prenatal care, at-risk enhanced service; education |
80 |
80 |
$0.00 |