| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,021 |
882 |
$55K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
479 |
416 |
$30K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
115 |
97 |
$8K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
47 |
41 |
$4K |
| 59025 |
Fetal non-stress test |
31 |
12 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$1K |
| 81025 |
|
166 |
120 |
$988.65 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
28 |
26 |
$547.24 |
| 90715 |
|
12 |
12 |
$530.88 |
| 92557 |
|
16 |
14 |
$426.16 |
| 90686 |
|
12 |
12 |
$221.04 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
19 |
12 |
$184.32 |
| 81002 |
|
34 |
30 |
$97.20 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
12 |
12 |
$0.00 |