| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,493 |
2,035 |
$160K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,715 |
2,183 |
$117K |
| 90686 |
|
120 |
73 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
17 |
12 |
$1K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
13 |
12 |
$963.89 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
15 |
15 |
$629.27 |
| 90734 |
|
19 |
12 |
$531.31 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
216 |
121 |
$198.90 |
| 81002 |
|
18 |
16 |
$46.39 |
| G2211 |
Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) |
26 |
26 |
$41.75 |
| 90461 |
|
27 |
20 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
264 |
168 |
$0.00 |