| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
4,096 |
3,721 |
$157K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
1,653 |
1,621 |
$44K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
158 |
156 |
$12K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
187 |
185 |
$3K |
| 99173 |
|
119 |
114 |
$2K |
| 3008F |
|
168 |
145 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
29 |
29 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
60 |
55 |
$2K |
| 92551 |
|
114 |
109 |
$1K |
| 0071A |
|
18 |
16 |
$610.56 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
41 |
38 |
$503.88 |
| 0072A |
|
13 |
13 |
$496.08 |
| 90686 |
|
128 |
113 |
$114.57 |
| 91307 |
|
38 |
37 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
198 |
163 |
$0.00 |
| 90461 |
|
59 |
25 |
$0.00 |