| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,027 |
1,621 |
$414K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
956 |
659 |
$128K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
505 |
481 |
$103K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
297 |
280 |
$51K |
| D0999 |
Unspecified diagnostic procedure, by report |
19 |
19 |
$8K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
28 |
26 |
$7K |
| 90837 |
Psychotherapy, 53 minutes with patient |
20 |
13 |
$3K |
| 99215 |
Prolong outpt/office vis |
17 |
16 |
$2K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
425 |
369 |
$832.78 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
370 |
317 |
$416.39 |
| 90686 |
|
297 |
285 |
$391.59 |
| G0467 |
Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit |
22 |
12 |
$294.40 |
| 90670 |
|
122 |
119 |
$242.00 |
| 90680 |
|
90 |
87 |
$199.31 |
| 90647 |
|
90 |
88 |
$119.55 |
| D1206 |
Topical application of fluoride varnish |
14 |
14 |
$110.00 |
| 90656 |
|
18 |
18 |
$26.25 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
791 |
743 |
$0.00 |
| 99000 |
|
363 |
332 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
439 |
391 |
$0.00 |
| 85018 |
|
128 |
122 |
$0.00 |
| 3074F |
|
36 |
30 |
$0.00 |
| 90698 |
|
43 |
41 |
$0.00 |
| 90474 |
|
12 |
12 |
$0.00 |
| 1159F |
|
142 |
118 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
878 |
420 |
$0.00 |
| 99173 |
|
14 |
13 |
$0.00 |
| 90633 |
|
13 |
13 |
$0.00 |
| 90473 |
|
40 |
40 |
$0.00 |
| 83655 |
|
17 |
16 |
$0.00 |
| D9996 |
|
15 |
15 |
$0.00 |
| 3078F |
|
24 |
19 |
$0.00 |