| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
738 |
539 |
$62K |
| 90716 |
|
404 |
288 |
$33K |
| 90651 |
|
230 |
165 |
$24K |
| 99215 |
Prolong outpt/office vis |
231 |
173 |
$18K |
| 90746 |
|
218 |
142 |
$15K |
| 90713 |
|
437 |
303 |
$13K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
206 |
160 |
$12K |
| 90686 |
|
428 |
305 |
$8K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
115 |
94 |
$7K |
| 90677 |
|
27 |
14 |
$6K |
| 90739 |
|
34 |
33 |
$5K |
| 90715 |
|
217 |
162 |
$5K |
| 90633 |
|
239 |
166 |
$4K |
| 91321 |
|
234 |
174 |
$4K |
| 90656 |
|
129 |
106 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
28 |
27 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
15 |
15 |
$1K |
| 90744 |
|
37 |
35 |
$619.11 |
| 0124A |
|
12 |
12 |
$507.14 |
| 91322 |
|
18 |
17 |
$301.62 |
| 90461 |
|
21 |
14 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
112 |
89 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
36 |
27 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
337 |
285 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
13 |
13 |
$0.00 |