| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
631 |
559 |
$22K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
305 |
286 |
$14K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
412 |
404 |
$12K |
| 99441 |
|
240 |
232 |
$8K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
87 |
87 |
$6K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
74 |
74 |
$4K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
141 |
141 |
$4K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
124 |
124 |
$4K |
| 90461 |
|
86 |
86 |
$3K |
| 99442 |
|
57 |
54 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
41 |
41 |
$3K |
| 90756 |
|
203 |
201 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
26 |
26 |
$2K |
| 99383 |
|
45 |
45 |
$1K |
| 99384 |
|
14 |
14 |
$446.14 |
| T1013 |
Sign language or oral interpretive services, per 15 minutes |
12 |
12 |
$79.75 |
| 90670 |
|
13 |
13 |
$0.00 |