| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
12,686 |
11,289 |
$65K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
2,073 |
2,056 |
$39K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,592 |
1,585 |
$29K |
| 90686 |
|
2,686 |
2,671 |
$17K |
| 92551 |
|
5,112 |
5,091 |
$14K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
428 |
421 |
$11K |
| 81000 |
|
4,946 |
4,907 |
$6K |
| 85018 |
|
7,678 |
7,461 |
$6K |
| 92552 |
|
322 |
322 |
$5K |
| 96156 |
|
1,284 |
1,280 |
$3K |
| 90651 |
|
703 |
698 |
$3K |
| 90734 |
|
405 |
401 |
$2K |
| 90620 |
|
422 |
413 |
$1K |
| 81002 |
|
633 |
633 |
$720.14 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
209 |
209 |
$679.10 |
| 99173 |
|
3,233 |
3,217 |
$463.10 |
| 96150 |
|
1,345 |
1,337 |
$459.03 |
| 90670 |
|
64 |
64 |
$351.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
5,524 |
5,509 |
$299.87 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
342 |
342 |
$282.94 |
| 90715 |
|
43 |
43 |
$225.00 |
| 99401 |
|
5,154 |
5,128 |
$211.74 |
| 81025 |
|
178 |
178 |
$114.89 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
89 |
70 |
$113.12 |
| 90633 |
|
16 |
16 |
$90.00 |
| 90680 |
|
12 |
12 |
$81.00 |
| 90700 |
|
12 |
12 |
$81.00 |
| 90744 |
|
12 |
12 |
$72.00 |
| 86580 |
|
25 |
25 |
$56.65 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
76 |
76 |
$45.92 |
| 92499 |
|
393 |
392 |
$7.50 |
| 97803 |
|
5,169 |
5,160 |
$0.47 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
2,040 |
2,037 |
$0.36 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
330 |
329 |
$0.01 |
| D0120 |
Periodic oral evaluation - established patient |
4,572 |
4,562 |
$0.00 |
| 3074F |
|
2,245 |
2,121 |
$0.00 |
| 3079F |
|
54 |
53 |
$0.00 |
| 99441 |
|
46 |
46 |
$0.00 |
| 99442 |
|
795 |
765 |
$0.00 |
| 3078F |
|
2,405 |
2,270 |
$0.00 |
| 3077F |
|
51 |
49 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
12 |
12 |
$0.00 |