| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
644 |
463 |
$20K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
285 |
238 |
$7K |
| 99233 |
Prolong inpt eval add15 m |
95 |
42 |
$5K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
53 |
44 |
$4K |
| 99223 |
Prolong inpt eval add15 m |
47 |
46 |
$3K |
| 90686 |
|
17 |
17 |
$352.35 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
50 |
50 |
$246.22 |
| 81002 |
|
519 |
362 |
$126.77 |
| 81025 |
|
40 |
39 |
$112.00 |
| 1126F |
|
15 |
12 |
$0.00 |
| 0502F |
|
425 |
291 |
$0.00 |