| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
14,489 |
12,479 |
$257K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
7,076 |
6,105 |
$185K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,457 |
1,157 |
$17K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,882 |
2,620 |
$17K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
337 |
309 |
$9K |
| 90837 |
Psychotherapy, 53 minutes with patient |
476 |
193 |
$6K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
130 |
115 |
$4K |
| 90686 |
|
2,401 |
2,195 |
$4K |
| T1023 |
Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter |
103 |
94 |
$3K |
| 90461 |
|
200 |
169 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
101 |
91 |
$3K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
266 |
235 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
125 |
118 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
28 |
24 |
$1K |
| 80305 |
|
741 |
544 |
$1K |
| 0012A |
|
35 |
34 |
$965.27 |
| 0011A |
|
35 |
33 |
$525.14 |
| 0071A |
|
16 |
12 |
$480.00 |
| 99215 |
Prolong outpt/office vis |
14 |
12 |
$275.62 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
13 |
12 |
$263.58 |
| 96127 |
|
122 |
105 |
$253.19 |
| 99205 |
Prolong outpt/office vis |
13 |
12 |
$181.08 |
| 92015 |
Determination of refractive state |
14 |
14 |
$169.64 |
| 90656 |
|
149 |
134 |
$80.57 |
| 99173 |
|
41 |
38 |
$64.44 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
13 |
13 |
$60.97 |
| 92551 |
|
39 |
38 |
$47.48 |
| 96160 |
|
86 |
79 |
$46.82 |
| 96161 |
|
15 |
13 |
$12.80 |
| 91301 |
|
62 |
61 |
$0.58 |
| 91307 |
|
21 |
14 |
$0.06 |