| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
7,533 |
6,684 |
$644K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,533 |
3,180 |
$464K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
3,734 |
3,497 |
$75K |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,000 |
808 |
$70K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
306 |
296 |
$36K |
| 90863 |
|
1,025 |
808 |
$31K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
953 |
899 |
$24K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
127 |
122 |
$15K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
128 |
121 |
$14K |
| 90834 |
Psychotherapy, 45 minutes with patient |
112 |
93 |
$10K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
77 |
73 |
$10K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
26 |
25 |
$4K |
| S0281 |
Medical home program, comprehensive care coordination and planning, maintenance of plan |
698 |
698 |
$3K |
| 90670 |
|
37 |
37 |
$1K |
| 0001A |
|
15 |
15 |
$600.00 |
| S0315 |
Disease management program; initial assessment and initiation of the program |
70 |
70 |
$525.00 |
| 0012A |
|
14 |
14 |
$520.00 |
| 0002A |
|
12 |
12 |
$480.00 |
| 90686 |
|
1,455 |
1,372 |
$409.96 |
| 90685 |
|
14 |
13 |
$35.70 |
| 91300 |
|
59 |
54 |
$0.00 |
| 90715 |
|
14 |
13 |
$0.00 |
| 90734 |
|
14 |
12 |
$0.00 |
| 90656 |
|
42 |
42 |
$0.00 |
| 91301 |
|
14 |
14 |
$0.00 |
| 90647 |
|
13 |
12 |
$0.00 |