| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,343 |
4,663 |
$594K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,119 |
5,321 |
$425K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,806 |
1,583 |
$192K |
| 98968 |
|
4,347 |
3,817 |
$166K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,196 |
1,174 |
$128K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
605 |
600 |
$66K |
| 90461 |
|
1,432 |
1,364 |
$62K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,290 |
2,166 |
$53K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
228 |
225 |
$25K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
424 |
412 |
$19K |
| 90670 |
|
895 |
867 |
$10K |
| S9999 |
Sales tax |
1,272 |
966 |
$9K |
| 92551 |
|
704 |
699 |
$8K |
| 99223 |
Prolong inpt eval add15 m |
16 |
16 |
$3K |
| 99215 |
Prolong outpt/office vis |
14 |
14 |
$3K |
| 90633 |
|
187 |
185 |
$2K |
| 90647 |
|
219 |
211 |
$1K |
| 90672 |
|
115 |
114 |
$1K |
| 90688 |
|
151 |
149 |
$1K |
| 90756 |
|
117 |
116 |
$972.30 |
| 90698 |
|
88 |
86 |
$600.00 |
| 90680 |
|
52 |
49 |
$420.00 |
| 98967 |
|
15 |
15 |
$383.84 |
| 90658 |
|
107 |
94 |
$356.99 |
| 90723 |
|
123 |
114 |
$355.70 |
| 90649 |
|
25 |
25 |
$344.52 |
| 90657 |
|
100 |
90 |
$156.75 |
| 90696 |
|
13 |
12 |
$150.00 |
| 90707 |
|
13 |
13 |
$120.00 |
| 90716 |
|
18 |
18 |
$60.00 |