| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,282 |
1,149 |
$40K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
273 |
243 |
$24K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
275 |
253 |
$16K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
520 |
510 |
$15K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
387 |
367 |
$15K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,272 |
698 |
$10K |
| 92552 |
|
974 |
970 |
$7K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
213 |
209 |
$7K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
23 |
12 |
$2K |
| 85018 |
|
894 |
864 |
$1K |
| 90648 |
|
167 |
167 |
$828.00 |
| 90670 |
|
161 |
161 |
$792.00 |
| 81000 |
|
665 |
657 |
$773.54 |
| 99173 |
|
238 |
238 |
$712.13 |
| 90700 |
|
137 |
137 |
$617.50 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
26 |
26 |
$397.62 |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
14 |
13 |
$381.11 |
| 90680 |
|
66 |
66 |
$369.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
87 |
87 |
$346.86 |
| 81003 |
|
118 |
116 |
$295.99 |
| 83026 |
|
100 |
100 |
$283.00 |
| 99000 |
|
79 |
75 |
$254.03 |
| 90658 |
|
108 |
102 |
$217.00 |
| 83655 |
|
16 |
15 |
$147.34 |
| 90649 |
|
48 |
48 |
$81.00 |
| 92081 |
|
355 |
352 |
$54.08 |
| 90707 |
|
12 |
12 |
$54.00 |
| 90633 |
|
27 |
26 |
$46.00 |
| 92551 |
|
12 |
12 |
$31.96 |
| 90461 |
|
12 |
12 |
$0.00 |
| 59425 |
|
19 |
12 |
$0.00 |