| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
20,159 |
17,770 |
$898K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
11,015 |
10,615 |
$672K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
1,867 |
1,862 |
$143K |
| 99397 |
|
1,392 |
1,390 |
$117K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
6,214 |
5,759 |
$71K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
342 |
342 |
$23K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
327 |
315 |
$11K |
| 0003A |
|
177 |
177 |
$8K |
| 0124A |
|
278 |
278 |
$8K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
77 |
77 |
$6K |
| 0004A |
|
121 |
121 |
$4K |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
109 |
109 |
$4K |
| 0013A |
|
93 |
93 |
$4K |
| 0064A |
|
102 |
102 |
$2K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
235 |
221 |
$2K |
| 90686 |
|
742 |
736 |
$2K |
| 99215 |
Prolong outpt/office vis |
26 |
25 |
$1K |
| 0002A |
|
31 |
31 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
118 |
118 |
$1K |
| G0008 |
Administration of influenza virus vaccine |
507 |
485 |
$849.11 |
| 0001A |
|
17 |
17 |
$733.92 |
| 90480 |
|
76 |
76 |
$495.05 |
| 90688 |
|
336 |
239 |
$398.71 |
| 99442 |
|
15 |
14 |
$245.51 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
12 |
12 |
$206.23 |
| 91312 |
|
232 |
232 |
$0.00 |
| 91300 |
|
305 |
304 |
$0.00 |
| 91320 |
|
18 |
18 |
$0.00 |
| 91306 |
|
81 |
81 |
$0.00 |
| 91301 |
|
108 |
108 |
$0.00 |