| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,904 |
1,688 |
$22K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
473 |
473 |
$11K |
| 92552 |
|
1,515 |
1,503 |
$8K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
351 |
348 |
$7K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
320 |
319 |
$4K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
396 |
242 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
86 |
83 |
$3K |
| 90686 |
|
528 |
483 |
$2K |
| 99383 |
|
70 |
65 |
$2K |
| 92551 |
|
253 |
250 |
$2K |
| 99384 |
|
45 |
44 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
210 |
206 |
$1K |
| 99173 |
|
1,251 |
1,240 |
$1K |
| 96156 |
|
108 |
106 |
$1K |
| 90700 |
|
71 |
67 |
$351.00 |
| 90651 |
|
111 |
110 |
$343.00 |
| 90713 |
|
69 |
65 |
$333.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
35 |
26 |
$282.80 |
| 90734 |
|
73 |
73 |
$218.00 |
| 92081 |
|
393 |
391 |
$208.08 |
| 90620 |
|
26 |
26 |
$103.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
785 |
774 |
$81.00 |
| 90715 |
|
25 |
25 |
$46.00 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
276 |
275 |
$36.00 |
| G0438 |
Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit |
43 |
40 |
$18.00 |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
14 |
14 |
$0.00 |
| 96127 |
|
35 |
35 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
58 |
56 |
$0.00 |
| G9920 |
Screening performed and negative |
39 |
37 |
$0.00 |
| 97803 |
|
89 |
87 |
$0.00 |