| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,672 |
4,405 |
$331K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,284 |
1,144 |
$60K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,378 |
1,225 |
$57K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,311 |
2,124 |
$51K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
374 |
332 |
$41K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
369 |
361 |
$39K |
| 90670 |
|
106 |
100 |
$31K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
226 |
224 |
$23K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
175 |
166 |
$18K |
| 90688 |
|
796 |
784 |
$16K |
| 90620 |
|
73 |
72 |
$13K |
| 90713 |
|
262 |
258 |
$8K |
| 90700 |
|
247 |
246 |
$7K |
| S9999 |
Sales tax |
964 |
799 |
$7K |
| 90677 |
|
18 |
17 |
$6K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
142 |
139 |
$4K |
| 90649 |
|
15 |
15 |
$3K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
12 |
12 |
$2K |
| 90716 |
|
25 |
25 |
$2K |
| 90648 |
|
85 |
84 |
$2K |
| 90461 |
|
27 |
27 |
$1K |
| 90715 |
|
30 |
29 |
$1K |
| 90707 |
|
16 |
15 |
$738.00 |
| 90744 |
|
15 |
15 |
$575.85 |
| 90633 |
|
13 |
13 |
$441.11 |