| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
8,044 |
7,096 |
$269K |
| 69210 |
|
1,651 |
1,648 |
$88K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
927 |
915 |
$63K |
| 92552 |
|
2,424 |
2,400 |
$56K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
491 |
491 |
$28K |
| 92551 |
|
1,405 |
1,391 |
$27K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
3,287 |
3,204 |
$25K |
| 90686 |
|
1,922 |
1,897 |
$18K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,463 |
1,457 |
$16K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
283 |
283 |
$16K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
222 |
222 |
$14K |
| 90620 |
|
210 |
209 |
$12K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
558 |
558 |
$10K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
737 |
707 |
$7K |
| 90656 |
|
190 |
190 |
$3K |
| 99173 |
|
2,773 |
2,743 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
14 |
14 |
$985.03 |
| 90658 |
|
17 |
17 |
$860.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
13 |
13 |
$685.11 |
| 99429 |
|
12 |
12 |
$300.00 |
| 3008F |
|
12 |
12 |
$300.00 |
| 86580 |
|
14 |
14 |
$77.02 |
| 90744 |
|
13 |
13 |
$43.75 |
| 90651 |
|
12 |
12 |
$11.07 |
| 90734 |
|
13 |
13 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
41 |
41 |
$0.00 |
| 92081 |
|
12 |
12 |
$0.00 |