| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,443 |
3,168 |
$233K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,102 |
1,086 |
$110K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
730 |
704 |
$70K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
602 |
571 |
$59K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,252 |
2,194 |
$48K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
426 |
415 |
$42K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,315 |
1,290 |
$24K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
217 |
209 |
$23K |
| 99383 |
|
95 |
91 |
$10K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
41 |
40 |
$6K |
| 99381 |
|
39 |
39 |
$5K |
| 95165 |
Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials |
109 |
13 |
$3K |
| 99384 |
|
14 |
14 |
$2K |
| 99382 |
|
13 |
13 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
13 |
13 |
$345.24 |
| 96127 |
|
63 |
61 |
$294.02 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
15 |
15 |
$111.00 |
| 81002 |
|
139 |
128 |
$31.40 |
| 90686 |
|
259 |
259 |
$0.00 |
| 90698 |
|
121 |
118 |
$0.00 |
| 3008F |
|
718 |
700 |
$0.00 |
| 90680 |
|
111 |
109 |
$0.00 |
| 90723 |
|
62 |
62 |
$0.00 |
| 90744 |
|
30 |
30 |
$0.00 |
| 90651 |
|
21 |
21 |
$0.00 |
| 90670 |
|
520 |
513 |
$0.00 |
| 90633 |
|
210 |
206 |
$0.00 |
| 99173 |
|
115 |
112 |
$0.00 |
| 90710 |
|
130 |
126 |
$0.00 |
| 90734 |
|
34 |
33 |
$0.00 |
| 90648 |
|
161 |
157 |
$0.00 |
| 90700 |
|
26 |
25 |
$0.00 |
| 90685 |
|
26 |
25 |
$0.00 |