| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,694 |
4,086 |
$257K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
7,086 |
6,106 |
$234K |
| 90686 |
|
495 |
455 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
491 |
434 |
$3K |
| 0012A |
|
42 |
41 |
$1K |
| 0011A |
|
44 |
43 |
$1K |
| 90682 |
|
26 |
26 |
$727.65 |
| 81003 |
|
1,256 |
1,109 |
$621.15 |
| 0064A |
|
17 |
17 |
$560.00 |
| 96127 |
|
163 |
126 |
$517.09 |
| 99173 |
|
209 |
187 |
$263.59 |
| 90656 |
|
14 |
12 |
$174.86 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
13 |
12 |
$106.30 |
| 81002 |
|
93 |
72 |
$6.82 |
| 91301 |
|
112 |
110 |
$0.24 |
| 91306 |
|
17 |
17 |
$0.09 |
| 91300 |
|
12 |
12 |
$0.01 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
136 |
119 |
$0.00 |
| 3078F |
|
202 |
188 |
$0.00 |
| 3008F |
|
7,252 |
6,054 |
$0.00 |
| 3074F |
|
392 |
350 |
$0.00 |
| 3079F |
|
147 |
132 |
$0.00 |