| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,567 |
1,537 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,569 |
1,525 |
$2K |
| 92552 |
|
190 |
190 |
$880.30 |
| 90688 |
|
41 |
37 |
$680.24 |
| 99173 |
|
229 |
229 |
$650.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
383 |
376 |
$529.46 |
| 90686 |
|
25 |
25 |
$311.42 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
28 |
28 |
$115.41 |
| 92551 |
|
24 |
24 |
$22.04 |
| 92081 |
|
64 |
64 |
$19.80 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
85 |
85 |
$10.69 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
49 |
47 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
14 |
14 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
16 |
16 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
25 |
25 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
38 |
38 |
$0.00 |
| 90649 |
|
16 |
16 |
$0.00 |
| 1159F |
|
16 |
16 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
13 |
13 |
$0.00 |
| 3008F |
|
568 |
555 |
$0.00 |
| 1220F |
|
154 |
154 |
$0.00 |
| 2000F |
|
125 |
122 |
$0.00 |
| 1000F |
|
14 |
14 |
$0.00 |
| 3700F |
|
13 |
13 |
$0.00 |