| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,718 |
5,033 |
$301K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,049 |
1,745 |
$124K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
183 |
161 |
$14K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
162 |
144 |
$14K |
| 90688 |
|
158 |
148 |
$2K |
| 90733 |
|
18 |
12 |
$2K |
| 90686 |
|
181 |
163 |
$1K |
| 0071A |
|
34 |
34 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
36 |
36 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
38 |
35 |
$1K |
| 0072A |
|
23 |
23 |
$974.22 |
| 90674 |
|
26 |
16 |
$747.97 |
| 0012A |
|
14 |
14 |
$557.30 |
| 0011A |
|
14 |
14 |
$324.40 |
| 90734 |
|
12 |
12 |
$206.77 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
70 |
57 |
$172.50 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
17 |
12 |
$17.70 |
| 3074F |
|
245 |
199 |
$1.01 |
| 3078F |
|
229 |
183 |
$1.01 |
| 91301 |
|
33 |
33 |
$0.27 |
| 3008F |
|
366 |
295 |
$0.00 |
| 2000F |
|
324 |
266 |
$0.00 |
| 91307 |
|
18 |
17 |
$0.00 |
| 3725F |
|
12 |
12 |
$0.00 |