| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,206 |
2,101 |
$85K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,121 |
3,047 |
$68K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
157 |
157 |
$10K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
129 |
129 |
$8K |
| G9007 |
Coordinated care fee, scheduled team conference |
25 |
25 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
25 |
25 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
48 |
47 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
24 |
24 |
$2K |
| 96127 |
|
363 |
363 |
$1K |
| 90686 |
|
641 |
638 |
$252.18 |
| 99441 |
|
16 |
16 |
$192.77 |
| 96160 |
|
53 |
53 |
$79.52 |
| 90461 |
|
94 |
93 |
$23.22 |
| 90656 |
|
73 |
73 |
$21.70 |
| 90651 |
|
15 |
15 |
$0.00 |
| 99499 |
|
38 |
38 |
$0.00 |
| 99080 |
|
527 |
522 |
$0.00 |
| 90734 |
|
12 |
12 |
$0.00 |