| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
9,811 |
9,210 |
$13K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,320 |
2,307 |
$3K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
123 |
122 |
$2K |
| 93000 |
|
1,959 |
1,955 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
118 |
117 |
$2K |
| 90658 |
|
1,630 |
1,608 |
$1K |
| 90686 |
|
337 |
336 |
$707.96 |
| 3074F |
|
727 |
719 |
$605.00 |
| 3078F |
|
665 |
655 |
$565.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
26 |
25 |
$264.74 |
| 3075F |
|
124 |
124 |
$220.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
58 |
58 |
$210.08 |
| 3079F |
|
328 |
327 |
$205.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
27 |
27 |
$128.87 |
| 3077F |
|
255 |
249 |
$120.00 |
| 86580 |
|
82 |
82 |
$116.82 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
46 |
44 |
$22.96 |
| 3080F |
|
82 |
79 |
$20.00 |
| 90649 |
|
28 |
28 |
$18.00 |
| 90734 |
|
13 |
13 |
$9.00 |
| 99386 |
|
29 |
29 |
$0.00 |
| 99385 |
|
12 |
12 |
$0.00 |
| 99442 |
|
1,007 |
947 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
60 |
60 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
15 |
15 |
$0.00 |