| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,629 |
1,264 |
$117K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,007 |
812 |
$47K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
419 |
328 |
$27K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
283 |
203 |
$22K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
112 |
75 |
$7K |
| 90686 |
|
497 |
340 |
$7K |
| 99215 |
Prolong outpt/office vis |
55 |
51 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
42 |
27 |
$3K |
| D1206 |
Topical application of fluoride varnish |
103 |
76 |
$3K |
| 90670 |
|
225 |
160 |
$3K |
| 90656 |
|
55 |
51 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
40 |
38 |
$997.75 |
| 36415 |
Collection of venous blood by venipuncture |
693 |
648 |
$951.84 |
| 90633 |
|
60 |
24 |
$919.60 |
| 90682 |
|
15 |
14 |
$853.72 |
| 90698 |
|
96 |
82 |
$614.40 |
| 90697 |
|
35 |
25 |
$531.88 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
14 |
14 |
$448.00 |
| 90677 |
|
22 |
19 |
$439.22 |
| 90671 |
|
14 |
14 |
$312.70 |
| 90680 |
|
28 |
25 |
$311.94 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
126 |
44 |
$0.00 |