| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99348 |
|
825 |
760 |
$14K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
22,606 |
18,489 |
$6K |
| 90630 |
|
476 |
448 |
$3K |
| 90651 |
|
730 |
710 |
$2K |
| 90734 |
|
560 |
541 |
$1K |
| 90620 |
|
326 |
312 |
$999.75 |
| 90715 |
|
381 |
368 |
$677.24 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
62 |
59 |
$673.00 |
| 90670 |
|
847 |
823 |
$428.00 |
| 90633 |
|
496 |
472 |
$364.14 |
| 90716 |
|
550 |
536 |
$314.00 |
| 90686 |
|
367 |
344 |
$300.09 |
| 90648 |
|
522 |
511 |
$286.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
616 |
544 |
$268.00 |
| 90707 |
|
432 |
423 |
$248.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
63 |
62 |
$236.00 |
| 90696 |
|
233 |
229 |
$202.62 |
| 90681 |
|
351 |
346 |
$196.00 |
| 90723 |
|
352 |
342 |
$150.00 |
| 90698 |
|
179 |
178 |
$96.00 |
| 90685 |
|
178 |
169 |
$68.00 |
| 99441 |
|
555 |
502 |
$65.15 |
| 90700 |
|
106 |
106 |
$56.00 |
| 90744 |
|
34 |
33 |
$36.00 |
| 99443 |
|
15 |
14 |
$25.00 |
| 90746 |
|
24 |
24 |
$20.00 |
| G0008 |
Administration of influenza virus vaccine |
310 |
257 |
$8.00 |
| 3078F |
|
2,693 |
2,552 |
$0.02 |
| 3074F |
|
2,544 |
2,398 |
$0.02 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
26 |
20 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
498 |
402 |
$0.00 |
| 3077F |
|
538 |
519 |
$0.00 |
| 3725F |
|
87 |
86 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
758 |
628 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
595 |
481 |
$0.00 |
| 1160F |
|
48 |
48 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
92 |
70 |
$0.00 |
| 90621 |
|
13 |
13 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
15 |
15 |
$0.00 |
| 99442 |
|
53 |
53 |
$0.00 |
| 1159F |
|
17 |
17 |
$0.00 |
| 3017F |
|
156 |
150 |
$0.00 |
| 3008F |
|
3,324 |
3,128 |
$0.00 |
| 3079F |
|
790 |
752 |
$0.00 |
| 1126F |
|
137 |
135 |
$0.00 |
| 3075F |
|
421 |
397 |
$0.00 |
| 3080F |
|
76 |
73 |
$0.00 |
| 99383 |
|
21 |
18 |
$0.00 |
| 99349 |
|
26 |
19 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
23 |
22 |
$0.00 |
| 99381 |
|
34 |
24 |
$0.00 |
| 3048F |
|
43 |
42 |
$0.00 |