| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 15003 |
|
2,155 |
1,384 |
$752K |
| 15002 |
|
4,341 |
2,895 |
$400K |
| 15004 |
|
2,207 |
1,550 |
$302K |
| 15274 |
|
1,194 |
799 |
$267K |
| 15273 |
|
1,335 |
1,011 |
$98K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,235 |
1,906 |
$58K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
725 |
696 |
$35K |
| 15005 |
|
147 |
82 |
$26K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
555 |
209 |
$19K |
| 15277 |
|
157 |
90 |
$11K |
| 17108 |
|
45 |
39 |
$10K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
672 |
594 |
$9K |
| 15278 |
|
73 |
41 |
$8K |
| 99219 |
|
76 |
66 |
$4K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
53 |
51 |
$1K |
| 99222 |
Initial hospital care, per day, moderate complexity |
19 |
12 |
$1K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
18 |
16 |
$1K |
| 15275 |
|
33 |
28 |
$884.98 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
13 |
13 |
$476.90 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
12 |
12 |
$160.88 |