| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,114 |
4,271 |
$454K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
743 |
706 |
$50K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
445 |
402 |
$41K |
| 99308 |
Subsequent nursing facility care, per day, straightforward |
153 |
139 |
$8K |
| 90686 |
|
354 |
343 |
$7K |
| 99309 |
Subsequent nursing facility care, per day, low to moderate complexity |
109 |
97 |
$6K |
| W0037 |
|
1,090 |
1,090 |
$3K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
64 |
56 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
17 |
14 |
$2K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
39 |
26 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
15 |
13 |
$2K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
18 |
13 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
13 |
13 |
$1K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
12 |
12 |
$1K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
31 |
28 |
$603.38 |
| 0011A |
|
15 |
15 |
$0.00 |
| 91301 |
|
43 |
35 |
$0.00 |
| 90656 |
|
56 |
55 |
$0.00 |
| 90651 |
|
13 |
12 |
$0.00 |