| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,977 |
3,080 |
$130K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,724 |
1,374 |
$92K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
445 |
336 |
$20K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
436 |
301 |
$19K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
223 |
183 |
$11K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
678 |
543 |
$10K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
986 |
732 |
$10K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
340 |
277 |
$8K |
| T1015 |
Clinic visit/encounter, all-inclusive |
150 |
137 |
$5K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
42 |
41 |
$3K |
| 90473 |
|
286 |
205 |
$2K |
| 99222 |
Initial hospital care, per day, moderate complexity |
17 |
15 |
$1K |
| 0012A |
|
69 |
34 |
$1K |
| 0011A |
|
89 |
47 |
$1K |
| 0072A |
|
27 |
17 |
$669.12 |
| 0002A |
|
41 |
31 |
$507.04 |
| 0071A |
|
12 |
12 |
$499.96 |
| 90686 |
|
225 |
194 |
$247.79 |
| 90647 |
|
229 |
208 |
$0.03 |
| 91300 |
|
96 |
59 |
$0.00 |
| 90633 |
|
84 |
81 |
$0.00 |
| 90670 |
|
330 |
302 |
$0.00 |
| 90710 |
|
64 |
60 |
$0.00 |
| 90685 |
|
100 |
89 |
$0.00 |
| 91307 |
|
42 |
30 |
$0.00 |
| 90680 |
|
224 |
204 |
$0.00 |
| 90723 |
|
131 |
124 |
$0.00 |
| 91301 |
|
78 |
71 |
$0.00 |
| 90696 |
|
14 |
13 |
$0.00 |