| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,043 |
4,510 |
$12K |
| 59425 |
|
172 |
134 |
$11K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,280 |
1,272 |
$10K |
| 90791 |
Psychiatric diagnostic evaluation |
93 |
90 |
$6K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,949 |
1,842 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
258 |
252 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
70 |
68 |
$901.94 |
| 99401 |
|
63 |
60 |
$895.82 |
| 85018 |
|
851 |
846 |
$854.89 |
| 90832 |
Psychotherapy, 30 minutes with patient |
209 |
207 |
$784.81 |
| 81003 |
|
479 |
383 |
$665.41 |
| 99173 |
|
315 |
315 |
$533.86 |
| 81025 |
|
61 |
56 |
$169.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
129 |
128 |
$112.17 |
| 92551 |
|
393 |
393 |
$61.20 |
| 90686 |
|
128 |
127 |
$47.62 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
660 |
585 |
$35.83 |
| 90688 |
|
24 |
24 |
$21.00 |
| 90670 |
|
49 |
48 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
101 |
101 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
44 |
44 |
$0.00 |
| 90633 |
|
14 |
14 |
$0.00 |
| 90656 |
|
226 |
226 |
$0.00 |
| 90647 |
|
58 |
57 |
$0.00 |
| 0012A |
|
12 |
12 |
$0.00 |
| 90723 |
|
12 |
12 |
$0.00 |
| 91301 |
|
12 |
12 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
13 |
13 |
$0.00 |
| 0001A |
|
18 |
18 |
$0.00 |
| 0011A |
|
13 |
13 |
$0.00 |