| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,334 |
4,871 |
$285K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,087 |
836 |
$67K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
361 |
335 |
$30K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
838 |
738 |
$20K |
| 99401 |
|
249 |
206 |
$4K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
40 |
39 |
$3K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
37 |
37 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
41 |
37 |
$3K |
| 90734 |
|
35 |
30 |
$1K |
| 99490 |
Ccm add 20min |
172 |
171 |
$1K |
| 0001A |
|
35 |
35 |
$920.50 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
74 |
66 |
$779.51 |
| 90688 |
|
66 |
56 |
$694.64 |
| 36415 |
Collection of venous blood by venipuncture |
328 |
281 |
$626.97 |
| 0002A |
|
14 |
14 |
$589.96 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
12 |
12 |
$479.05 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
149 |
113 |
$362.50 |
| 86580 |
|
84 |
55 |
$332.00 |
| 90686 |
|
22 |
19 |
$180.34 |
| 36416 |
|
26 |
14 |
$98.40 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
20 |
12 |
$74.62 |
| 1000F |
|
32 |
31 |
$0.00 |
| 3074F |
|
198 |
185 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
15 |
12 |
$0.00 |
| 1036F |
|
17 |
17 |
$0.00 |
| 3351F |
|
12 |
12 |
$0.00 |
| 1220F |
|
13 |
13 |
$0.00 |
| 3078F |
|
199 |
189 |
$0.00 |