| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
17,073 |
12,784 |
$941K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
15,282 |
12,307 |
$603K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
4,155 |
3,714 |
$284K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
4,424 |
4,035 |
$282K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
7,015 |
5,992 |
$169K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,386 |
2,134 |
$151K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
7,551 |
6,761 |
$98K |
| 92551 |
|
11,051 |
9,818 |
$79K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
4,119 |
3,688 |
$57K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
671 |
556 |
$37K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
356 |
327 |
$21K |
| 99173 |
|
12,035 |
9,965 |
$18K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
172 |
151 |
$15K |
| 81002 |
|
6,379 |
5,597 |
$14K |
| 99384 |
|
102 |
95 |
$8K |
| 99383 |
|
73 |
70 |
$6K |
| 99051 |
|
338 |
315 |
$5K |
| 99382 |
|
50 |
47 |
$4K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
15 |
15 |
$1K |
| 85018 |
|
226 |
212 |
$495.60 |
| 83655 |
|
116 |
63 |
$397.32 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
15 |
15 |
$202.56 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
310 |
257 |
$160.73 |
| 90474 |
|
12 |
12 |
$109.56 |
| 99499 |
|
12 |
12 |
$108.00 |
| 36415 |
Collection of venous blood by venipuncture |
33 |
28 |
$64.50 |
| 90686 |
|
2,088 |
1,474 |
$0.00 |
| 90620 |
|
1,233 |
1,059 |
$0.00 |
| 90696 |
|
215 |
176 |
$0.00 |
| 90723 |
|
81 |
71 |
$0.00 |
| 90698 |
|
18 |
12 |
$0.00 |
| 90716 |
|
65 |
53 |
$0.00 |
| 90656 |
|
18 |
15 |
$0.00 |
| 90680 |
|
12 |
12 |
$0.00 |
| 90715 |
|
630 |
483 |
$0.00 |
| 90633 |
|
1,124 |
872 |
$0.00 |
| 90649 |
|
2,202 |
1,665 |
$0.00 |
| 90734 |
|
1,753 |
1,405 |
$0.00 |
| 90710 |
|
226 |
183 |
$0.00 |
| 90648 |
|
247 |
193 |
$0.00 |
| 90670 |
|
822 |
613 |
$0.00 |
| 90707 |
|
62 |
52 |
$0.00 |
| 90700 |
|
35 |
27 |
$0.00 |