| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,841 |
3,926 |
$233K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,672 |
1,407 |
$44K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
197 |
184 |
$17K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
192 |
176 |
$17K |
| 92552 |
|
777 |
696 |
$15K |
| Q3014 |
Telehealth originating site facility fee |
682 |
614 |
$14K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
368 |
350 |
$12K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
97 |
89 |
$8K |
| 90461 |
|
129 |
103 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
91 |
54 |
$2K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
38 |
28 |
$1K |
| 90480 |
|
36 |
34 |
$1K |
| 99460 |
|
14 |
13 |
$1K |
| 90682 |
|
89 |
50 |
$730.00 |
| 99497 |
|
44 |
18 |
$674.88 |
| 90473 |
|
30 |
29 |
$521.27 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
32 |
31 |
$450.07 |
| 0124A |
|
14 |
13 |
$445.23 |
| 85018 |
|
217 |
206 |
$274.16 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
17 |
13 |
$224.44 |
| 81002 |
|
106 |
100 |
$144.87 |
| 92551 |
|
12 |
12 |
$116.71 |
| 83655 |
|
12 |
12 |
$94.97 |
| 99173 |
|
406 |
371 |
$71.58 |
| 94760 |
|
66 |
61 |
$68.41 |
| 96127 |
|
14 |
14 |
$67.48 |
| 90688 |
|
325 |
284 |
$29.77 |
| 90656 |
|
47 |
41 |
$26.96 |
| 90686 |
|
176 |
133 |
$15.15 |
| 90672 |
|
129 |
113 |
$8.41 |
| 91312 |
|
14 |
13 |
$0.03 |
| 91308 |
|
14 |
13 |
$0.02 |
| 91300 |
|
37 |
32 |
$0.01 |
| 90649 |
|
12 |
12 |
$0.00 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
22 |
13 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
30 |
17 |
$0.00 |
| 91307 |
|
20 |
18 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
19 |
12 |
$0.00 |