| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,555 |
4,775 |
$136K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
139 |
134 |
$42K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
174 |
174 |
$12K |
| 99215 |
Prolong outpt/office vis |
156 |
148 |
$11K |
| 90686 |
|
780 |
780 |
$10K |
| 92551 |
|
707 |
707 |
$9K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
102 |
98 |
$7K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
124 |
124 |
$6K |
| A4267 |
Contraceptive supply, condom, male, each |
345 |
345 |
$5K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
82 |
53 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
44 |
41 |
$3K |
| 90658 |
|
143 |
143 |
$3K |
| S9445 |
Patient education, not otherwise classified, non-physician provider, individual, per session |
223 |
223 |
$3K |
| 81000 |
|
804 |
803 |
$2K |
| 99205 |
Prolong outpt/office vis |
18 |
18 |
$2K |
| 85018 |
|
879 |
877 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
350 |
348 |
$1K |
| 99000 |
|
164 |
164 |
$595.32 |
| 90656 |
|
15 |
14 |
$403.59 |
| 85999 |
|
123 |
123 |
$370.23 |
| 99173 |
|
97 |
97 |
$296.38 |