| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,624 |
1,539 |
$11K |
| 92552 |
|
390 |
390 |
$4K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
164 |
164 |
$3K |
| G9920 |
Screening performed and negative |
834 |
833 |
$2K |
| 90670 |
|
209 |
209 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
430 |
422 |
$1K |
| 90648 |
|
154 |
154 |
$987.00 |
| 90723 |
|
127 |
127 |
$819.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
199 |
199 |
$580.10 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
80 |
77 |
$512.50 |
| 90686 |
|
64 |
64 |
$402.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
91 |
91 |
$252.56 |
| 90680 |
|
31 |
31 |
$216.00 |
| 90633 |
|
25 |
25 |
$153.00 |
| 90716 |
|
24 |
24 |
$144.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
28 |
28 |
$115.41 |
| G2010 |
Remote evaluation of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment |
105 |
105 |
$86.08 |
| 90707 |
|
12 |
12 |
$72.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
27 |
27 |
$45.92 |
| 94760 |
|
1,671 |
1,594 |
$32.68 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
312 |
309 |
$31.38 |
| 85018 |
|
415 |
415 |
$22.96 |
| 81003 |
|
277 |
271 |
$15.50 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
24 |
24 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
61 |
61 |
$0.00 |
| 1036F |
|
14 |
14 |
$0.00 |
| 99173 |
|
386 |
386 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
146 |
146 |
$0.00 |
| 96160 |
|
253 |
253 |
$0.00 |