| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
575 |
568 |
$24K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
86 |
86 |
$7K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
628 |
627 |
$7K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
77 |
77 |
$6K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
29 |
29 |
$2K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
264 |
263 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
27 |
27 |
$2K |
| 99460 |
|
17 |
17 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
27 |
26 |
$1K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
13 |
13 |
$694.20 |
| 90686 |
|
157 |
157 |
$682.06 |
| 90688 |
|
15 |
15 |
$267.60 |
| 90651 |
|
12 |
12 |
$220.80 |
| 90633 |
|
12 |
12 |
$202.40 |
| 96161 |
|
13 |
13 |
$54.21 |
| 2014F |
|
149 |
149 |
$0.00 |
| 90670 |
|
25 |
25 |
$0.00 |
| 3008F |
|
429 |
429 |
$0.00 |
| 90698 |
|
12 |
12 |
$0.00 |