| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
6,947 |
6,292 |
$271K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,590 |
6,105 |
$267K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
508 |
503 |
$62K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
159 |
158 |
$17K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
479 |
451 |
$11K |
| 92552 |
|
802 |
800 |
$9K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
83 |
83 |
$6K |
| 99385 |
|
53 |
53 |
$5K |
| 90688 |
|
194 |
193 |
$4K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
51 |
51 |
$3K |
| 99173 |
|
868 |
865 |
$3K |
| 96151 |
|
784 |
781 |
$2K |
| 90686 |
|
227 |
226 |
$2K |
| 81002 |
|
1,148 |
1,129 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
209 |
209 |
$2K |
| 96150 |
|
410 |
402 |
$1K |
| 93000 |
|
42 |
42 |
$1K |
| 99386 |
|
15 |
15 |
$1K |
| 85018 |
|
878 |
875 |
$1K |
| 90657 |
|
97 |
96 |
$1K |
| 96156 |
|
221 |
221 |
$1K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
24 |
24 |
$474.14 |
| 92551 |
|
40 |
40 |
$443.96 |
| 90649 |
|
40 |
40 |
$438.75 |
| 99188 |
|
17 |
17 |
$372.50 |
| 90620 |
|
33 |
33 |
$348.75 |
| 90734 |
|
29 |
29 |
$303.75 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
12 |
12 |
$190.44 |
| D1206 |
Topical application of fluoride varnish |
13 |
13 |
$112.50 |
| 87210 |
|
53 |
53 |
$59.10 |
| 86580 |
|
28 |
28 |
$57.12 |
| 1157F |
|
176 |
176 |
$52.06 |
| 1170F |
|
978 |
975 |
$52.06 |
| 1159F |
|
425 |
423 |
$52.06 |
| 1158F |
|
343 |
343 |
$52.06 |
| 1160F |
|
625 |
623 |
$40.68 |
| 3044F |
|
103 |
95 |
$30.34 |
| 1125F |
|
94 |
94 |
$21.72 |
| 3078F |
|
466 |
465 |
$21.72 |
| 1126F |
|
978 |
977 |
$20.86 |
| 3079F |
|
209 |
207 |
$20.86 |
| 3077F |
|
19 |
19 |
$11.38 |
| 3074F |
|
711 |
710 |
$9.48 |
| 3061F |
|
890 |
890 |
$9.48 |
| 99401 |
|
319 |
317 |
$8.95 |
| 3008F |
|
2,206 |
2,197 |
$0.00 |
| 99050 |
|
142 |
138 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
14 |
14 |
$0.00 |
| 4037F |
|
172 |
171 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
161 |
160 |
$0.00 |
| 3075F |
|
37 |
37 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
60 |
53 |
$0.00 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
40 |
40 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
13 |
13 |
$0.00 |