| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
10,055 |
8,958 |
$11K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,527 |
2,402 |
$6K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
226 |
226 |
$5K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
3,273 |
3,037 |
$4K |
| 92552 |
|
666 |
666 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
136 |
136 |
$3K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
245 |
244 |
$1K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
283 |
203 |
$1K |
| 90688 |
|
127 |
126 |
$778.16 |
| 93000 |
|
53 |
41 |
$614.48 |
| 99173 |
|
629 |
629 |
$560.08 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
211 |
210 |
$431.23 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
16 |
16 |
$236.60 |
| 90756 |
|
44 |
44 |
$171.00 |
| 99385 |
|
311 |
311 |
$170.11 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
12 |
12 |
$145.01 |
| 90658 |
|
57 |
57 |
$135.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
55 |
55 |
$119.61 |
| 99386 |
|
297 |
297 |
$118.98 |
| 85018 |
|
87 |
87 |
$107.76 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
78 |
77 |
$66.90 |
| 90716 |
|
13 |
13 |
$36.00 |
| 90734 |
|
14 |
14 |
$27.00 |
| 1126F |
|
513 |
513 |
$0.00 |
| 1125F |
|
467 |
456 |
$0.00 |
| 99406 |
|
12 |
12 |
$0.00 |
| 3080F |
|
31 |
28 |
$0.00 |
| 3351F |
|
618 |
617 |
$0.00 |
| 3354F |
|
71 |
71 |
$0.00 |
| 3079F |
|
13 |
12 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
192 |
191 |
$0.00 |
| 3077F |
|
189 |
182 |
$0.00 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
62 |
62 |
$0.00 |