| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
7,448 |
4,463 |
$568K |
| 11721 |
|
1,896 |
1,757 |
$437K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,462 |
993 |
$120K |
| X5622 |
|
589 |
579 |
$78K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
340 |
295 |
$23K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
198 |
156 |
$9K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
32 |
32 |
$1K |
| 91320 |
|
106 |
60 |
$925.30 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
98 |
87 |
$905.58 |
| 90480 |
|
152 |
91 |
$260.00 |
| 99188 |
|
51 |
26 |
$163.29 |
| 90686 |
|
944 |
684 |
$67.05 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
471 |
370 |
$43.07 |
| 90656 |
|
157 |
93 |
$22.35 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,127 |
1,432 |
$21.53 |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
1,031 |
707 |
$0.03 |
| 92551 |
|
332 |
228 |
$0.00 |
| 96127 |
|
80 |
54 |
$0.00 |
| 0072A |
|
38 |
38 |
$0.00 |
| T1013 |
Sign language or oral interpretive services, per 15 minutes |
713 |
416 |
$0.00 |
| 90670 |
|
48 |
48 |
$0.00 |
| 99173 |
|
312 |
227 |
$0.00 |
| 0004A |
|
56 |
56 |
$0.00 |
| 0071A |
|
70 |
64 |
$0.00 |
| 0124A |
|
73 |
42 |
$0.00 |