| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,474 |
2,266 |
$142K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,193 |
1,121 |
$100K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
490 |
488 |
$36K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
433 |
430 |
$35K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,753 |
1,724 |
$16K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
518 |
513 |
$7K |
| 96127 |
|
693 |
687 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
27 |
27 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
25 |
25 |
$2K |
| 0071A |
|
14 |
14 |
$529.90 |
| 0072A |
|
13 |
13 |
$454.20 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
39 |
39 |
$424.53 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
15 |
12 |
$259.00 |
| 85018 |
|
12 |
12 |
$23.52 |
| 90656 |
|
35 |
35 |
$22.35 |
| 90686 |
|
756 |
753 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
316 |
315 |
$0.00 |
| 36416 |
|
58 |
58 |
$0.00 |
| 91307 |
|
31 |
28 |
$0.00 |
| G9920 |
Screening performed and negative |
162 |
162 |
$0.00 |
| 90734 |
|
14 |
14 |
$0.00 |
| 91300 |
|
19 |
14 |
$0.00 |
| 90621 |
|
13 |
13 |
$0.00 |