| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,454 |
1,225 |
$48.00 |
| 81025 |
|
325 |
312 |
$2.80 |
| 81002 |
|
40 |
40 |
$1.72 |
| 99173 |
|
27 |
27 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
22 |
22 |
$0.00 |
| 99401 |
|
32 |
32 |
$0.00 |
| 3077F |
|
16 |
16 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
152 |
143 |
$0.00 |
| 97803 |
|
28 |
28 |
$0.00 |
| 3078F |
|
13 |
12 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
22 |
22 |
$0.00 |
| 88147 |
|
12 |
12 |
$0.00 |
| 92552 |
|
14 |
14 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
16 |
16 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
32 |
32 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
130 |
125 |
$0.00 |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
100 |
67 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
79 |
79 |
$0.00 |
| 90686 |
|
42 |
42 |
$0.00 |
| 90674 |
|
51 |
51 |
$0.00 |