| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,090 |
4,285 |
$42K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,541 |
1,513 |
$20K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
484 |
482 |
$15K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
420 |
417 |
$11K |
| 92552 |
|
1,070 |
1,068 |
$9K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
264 |
264 |
$8K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
138 |
131 |
$4K |
| 92551 |
|
1,055 |
1,054 |
$3K |
| 99384 |
|
142 |
142 |
$2K |
| 92015 |
Determination of refractive state |
1,637 |
1,634 |
$2K |
| 90686 |
|
494 |
494 |
$1K |
| 99383 |
|
73 |
73 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
106 |
101 |
$327.50 |
| 90651 |
|
157 |
157 |
$275.30 |
| 90620 |
|
93 |
93 |
$184.73 |
| 99173 |
|
46 |
46 |
$132.02 |
| 90670 |
|
31 |
31 |
$99.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
12 |
12 |
$96.96 |
| 90698 |
|
21 |
21 |
$72.00 |
| 90734 |
|
129 |
129 |
$71.64 |
| 90680 |
|
12 |
12 |
$45.00 |
| 90658 |
|
34 |
34 |
$35.64 |
| 90716 |
|
12 |
12 |
$26.73 |
| 90707 |
|
12 |
12 |
$26.73 |
| 90461 |
|
70 |
61 |
$0.00 |