| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,578 |
3,227 |
$311K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,611 |
1,467 |
$198K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,986 |
2,871 |
$60K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
369 |
353 |
$44K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
730 |
714 |
$19K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
160 |
153 |
$18K |
| 90832 |
Psychotherapy, 30 minutes with patient |
219 |
122 |
$10K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
40 |
40 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
13 |
12 |
$2K |
| 99443 |
|
15 |
15 |
$1K |
| S0281 |
Medical home program, comprehensive care coordination and planning, maintenance of plan |
192 |
192 |
$798.72 |
| 90670 |
|
93 |
89 |
$648.88 |
| 90474 |
|
30 |
28 |
$398.49 |
| 90723 |
|
24 |
24 |
$142.42 |
| 90686 |
|
1,394 |
1,362 |
$119.88 |
| 90647 |
|
30 |
28 |
$50.12 |
| 90685 |
|
13 |
13 |
$35.70 |
| 90672 |
|
13 |
12 |
$0.00 |
| 90656 |
|
63 |
63 |
$0.00 |