| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,036 |
3,666 |
$189K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,040 |
968 |
$60K |
| 99310 |
Prolong nursin fac eval 15m |
367 |
366 |
$13K |
| S0281 |
Medical home program, comprehensive care coordination and planning, maintenance of plan |
4,021 |
4,014 |
$12K |
| 99307 |
|
446 |
436 |
$5K |
| 99308 |
Subsequent nursing facility care, per day, straightforward |
236 |
233 |
$3K |
| 99309 |
Subsequent nursing facility care, per day, low to moderate complexity |
53 |
53 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$1K |
| 99215 |
Prolong outpt/office vis |
13 |
12 |
$1K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
27 |
25 |
$693.00 |
| 90686 |
|
56 |
30 |
$494.78 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
28 |
26 |
$372.15 |
| 0002A |
|
14 |
14 |
$170.34 |