| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90670 |
|
176 |
174 |
$200.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,788 |
1,752 |
$55.68 |
| 90696 |
|
101 |
99 |
$52.22 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
348 |
343 |
$39.85 |
| 86580 |
|
273 |
266 |
$15.81 |
| 85014 |
|
225 |
224 |
$0.00 |
| 99173 |
|
633 |
631 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
4,579 |
4,166 |
$0.00 |
| 90649 |
|
109 |
107 |
$0.00 |
| 81002 |
|
203 |
202 |
$0.00 |
| 82947 |
|
576 |
539 |
$0.00 |
| 99382 |
|
44 |
44 |
$0.00 |
| 83655 |
|
166 |
165 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
205 |
205 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
228 |
228 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
138 |
137 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
182 |
180 |
$0.00 |
| 90707 |
|
27 |
26 |
$0.00 |
| 97803 |
|
40 |
39 |
$0.00 |
| 90715 |
|
79 |
78 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
163 |
161 |
$0.00 |
| 92557 |
|
317 |
317 |
$0.00 |
| 90710 |
|
110 |
110 |
$0.00 |
| 92081 |
|
259 |
259 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
74 |
74 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
12 |
12 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
152 |
150 |
$0.00 |
| 90734 |
|
132 |
131 |
$0.00 |
| 90633 |
|
138 |
136 |
$0.00 |
| 90700 |
|
55 |
55 |
$0.00 |
| 90658 |
|
158 |
158 |
$0.00 |
| 90713 |
|
13 |
13 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
13 |
12 |
$0.00 |
| 92551 |
|
584 |
579 |
$0.00 |
| 93000 |
|
334 |
330 |
$0.00 |
| 90680 |
|
45 |
44 |
$0.00 |
| 85018 |
|
1,079 |
1,072 |
$0.00 |
| 99383 |
|
85 |
85 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,921 |
4,651 |
$0.00 |
| 90698 |
|
97 |
96 |
$0.00 |
| 99384 |
|
86 |
86 |
$0.00 |
| 3353F |
|
41 |
41 |
$0.00 |
| 90744 |
|
52 |
51 |
$0.00 |
| 99000 |
|
1,813 |
1,753 |
$0.00 |
| 99385 |
|
156 |
155 |
$0.00 |
| 3351F |
|
62 |
62 |
$0.00 |
| 97802 |
|
122 |
120 |
$0.00 |
| 3352F |
|
31 |
31 |
$0.00 |
| 90620 |
|
51 |
51 |
$0.00 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
59 |
59 |
$0.00 |
| 3354F |
|
30 |
30 |
$0.00 |
| 90647 |
|
33 |
32 |
$0.00 |
| 90651 |
|
21 |
21 |
$0.00 |
| 81000 |
|
56 |
54 |
$0.00 |
| 90723 |
|
17 |
16 |
$0.00 |
| 90716 |
|
30 |
29 |
$0.00 |
| G9012 |
Other specified case management service not elsewhere classified |
626 |
595 |
$0.00 |
| 99386 |
|
39 |
39 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
13 |
13 |
$0.00 |