| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
7,274 |
4,196 |
$180K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,375 |
1,060 |
$65K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
155 |
146 |
$10K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
168 |
144 |
$9K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
262 |
93 |
$7K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
188 |
171 |
$6K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
197 |
58 |
$6K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,144 |
576 |
$3K |
| G0467 |
Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit |
374 |
224 |
$998.92 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
69 |
14 |
$886.91 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
348 |
164 |
$786.86 |
| 85018 |
|
1,341 |
641 |
$681.56 |
| 81025 |
|
747 |
392 |
$505.88 |
| T1015 |
Clinic visit/encounter, all-inclusive |
13 |
12 |
$360.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
13 |
12 |
$263.06 |
| 99454 |
|
26 |
26 |
$234.90 |
| 99406 |
|
67 |
51 |
$144.74 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
111 |
79 |
$144.57 |
| 91301 |
|
18 |
16 |
$120.00 |
| 3008F |
|
5,049 |
2,776 |
$109.96 |
| 81002 |
|
514 |
312 |
$94.87 |
| 90633 |
|
64 |
36 |
$90.00 |
| 99408 |
|
356 |
221 |
$80.37 |
| 0011A |
|
24 |
16 |
$80.00 |
| 1036F |
|
1,665 |
679 |
$25.80 |
| 90656 |
|
121 |
39 |
$11.80 |
| 82947 |
|
45 |
41 |
$5.68 |
| 1000F |
|
709 |
431 |
$0.01 |
| 99177 |
|
601 |
201 |
$0.00 |
| 4004F |
|
915 |
478 |
$0.00 |
| 90658 |
|
33 |
24 |
$0.00 |
| 90461 |
|
19 |
14 |
$0.00 |
| 90734 |
|
23 |
18 |
$0.00 |
| 3351F |
|
968 |
522 |
$0.00 |
| 1034F |
|
762 |
252 |
$0.00 |
| 92551 |
|
56 |
46 |
$0.00 |
| 3352F |
|
40 |
40 |
$0.00 |
| 2000F |
|
15 |
14 |
$0.00 |
| 2001F |
|
15 |
14 |
$0.00 |