| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,681 |
3,892 |
$174K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,973 |
1,599 |
$100K |
| 90686 |
|
1,568 |
1,339 |
$16K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
165 |
144 |
$13K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
206 |
191 |
$12K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
224 |
196 |
$8K |
| 92551 |
|
1,176 |
1,030 |
$7K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,891 |
1,589 |
$6K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
40 |
32 |
$4K |
| 99173 |
|
1,056 |
944 |
$2K |
| 96127 |
|
1,078 |
949 |
$1K |
| 90656 |
|
70 |
70 |
$1K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
15 |
12 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
17 |
12 |
$1K |
| 81002 |
|
593 |
474 |
$811.65 |
| 99442 |
|
18 |
13 |
$601.64 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
68 |
55 |
$406.68 |
| 99441 |
|
15 |
13 |
$301.56 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
16 |
15 |
$205.56 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
255 |
218 |
$185.81 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
12 |
12 |
$165.22 |
| 90688 |
|
36 |
32 |
$44.20 |
| 90658 |
|
19 |
19 |
$34.45 |
| 90670 |
|
13 |
12 |
$22.07 |
| 3725F |
|
43 |
39 |
$0.00 |
| 90461 |
|
284 |
226 |
$0.00 |
| 3078F |
|
972 |
775 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
952 |
796 |
$0.00 |
| 3077F |
|
21 |
12 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
13 |
13 |
$0.00 |
| 3008F |
|
2,740 |
2,123 |
$0.00 |
| 3075F |
|
306 |
233 |
$0.00 |
| 3079F |
|
469 |
360 |
$0.00 |
| 3044F |
|
206 |
149 |
$0.00 |
| 3074F |
|
1,083 |
867 |
$0.00 |
| 1036F |
|
123 |
103 |
$0.00 |
| 4037F |
|
83 |
57 |
$0.00 |
| 94760 |
|
15 |
14 |
$0.00 |