| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,273 |
3,159 |
$161K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,174 |
2,960 |
$105K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
477 |
463 |
$16K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
167 |
161 |
$15K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
650 |
642 |
$13K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
116 |
108 |
$11K |
| 90688 |
|
406 |
397 |
$5K |
| 3074F |
|
609 |
582 |
$4K |
| 3078F |
|
544 |
519 |
$4K |
| 99173 |
|
697 |
673 |
$3K |
| 90658 |
|
40 |
39 |
$557.48 |
| 3077F |
|
90 |
81 |
$410.00 |
| 3079F |
|
87 |
82 |
$380.00 |
| 3080F |
|
63 |
58 |
$280.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
219 |
197 |
$204.57 |
| 3075F |
|
16 |
15 |
$60.00 |
| 97802 |
|
35 |
24 |
$0.00 |