| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
5,862 |
5,266 |
$7K |
| 99173 |
|
3,036 |
3,000 |
$2.79 |
| 85014 |
|
3,549 |
3,496 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
464 |
459 |
$0.00 |
| 90707 |
|
105 |
104 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,262 |
1,260 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
91 |
91 |
$0.00 |
| 90461 |
|
120 |
113 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,016 |
1,009 |
$0.00 |
| 92552 |
|
3,035 |
3,000 |
$0.00 |
| 90715 |
|
75 |
75 |
$0.00 |
| 3078F |
|
649 |
639 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
502 |
492 |
$0.00 |
| 90670 |
|
158 |
150 |
$0.00 |
| 83655 |
|
385 |
384 |
$0.00 |
| 90633 |
|
45 |
44 |
$0.00 |
| 81002 |
|
91 |
91 |
$0.00 |
| 90734 |
|
358 |
357 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
386 |
301 |
$0.00 |
| G0438 |
Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit |
84 |
84 |
$0.00 |
| 90648 |
|
139 |
135 |
$0.00 |
| 90658 |
|
225 |
224 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
59 |
50 |
$0.00 |
| 90672 |
|
17 |
17 |
$0.00 |
| 90621 |
|
36 |
36 |
$0.00 |
| 3077F |
|
12 |
12 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,772 |
4,486 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
293 |
285 |
$0.00 |
| 96127 |
|
309 |
305 |
$0.00 |
| 3074F |
|
674 |
663 |
$0.00 |
| 81000 |
|
1,525 |
1,493 |
$0.00 |
| 90651 |
|
409 |
409 |
$0.00 |
| 90686 |
|
1,499 |
1,490 |
$0.00 |
| 90716 |
|
118 |
117 |
$0.00 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
14 |
14 |
$0.00 |
| 90723 |
|
45 |
40 |
$0.00 |
| 90620 |
|
58 |
58 |
$0.00 |
| 90696 |
|
12 |
12 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
86 |
86 |
$0.00 |