| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
196 |
195 |
$4K |
| 92551 |
|
510 |
507 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
113 |
112 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
61 |
61 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
172 |
169 |
$866.90 |
| 90686 |
|
280 |
276 |
$666.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
148 |
147 |
$483.70 |
| 85018 |
|
391 |
390 |
$483.67 |
| 92552 |
|
194 |
194 |
$443.33 |
| 90685 |
|
44 |
43 |
$190.00 |
| 81000 |
|
104 |
102 |
$156.57 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,309 |
1,225 |
$107.70 |
| 99173 |
|
181 |
181 |
$105.07 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
219 |
208 |
$49.50 |
| 83026 |
|
16 |
16 |
$43.20 |
| 81002 |
|
15 |
15 |
$38.70 |
| 92081 |
|
489 |
487 |
$32.70 |
| 90734 |
|
14 |
13 |
$9.00 |
| 90658 |
|
33 |
33 |
$9.00 |
| 90688 |
|
34 |
34 |
$9.00 |
| 90649 |
|
14 |
12 |
$0.00 |
| 3008F |
|
145 |
145 |
$0.00 |
| 97802 |
|
307 |
305 |
$0.00 |