| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,163 |
3,790 |
$129K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
675 |
600 |
$48K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
685 |
598 |
$44K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
489 |
415 |
$35K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
667 |
637 |
$30K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,762 |
1,339 |
$23K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
242 |
211 |
$16K |
| 90461 |
|
1,898 |
536 |
$3K |
| 90670 |
|
96 |
68 |
$808.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
78 |
67 |
$804.32 |
| 90651 |
|
62 |
61 |
$735.00 |
| 92551 |
|
287 |
279 |
$535.20 |
| 90686 |
|
167 |
145 |
$338.93 |
| 92552 |
|
166 |
97 |
$245.34 |
| 90672 |
|
18 |
17 |
$23.70 |
| 99173 |
|
456 |
381 |
$0.00 |
| 90715 |
|
12 |
12 |
$0.00 |
| 90710 |
|
46 |
26 |
$0.00 |
| 90734 |
|
45 |
29 |
$0.00 |
| 90633 |
|
58 |
53 |
$0.00 |
| 90648 |
|
21 |
12 |
$0.00 |
| 90680 |
|
14 |
14 |
$0.00 |
| 90619 |
|
12 |
12 |
$0.00 |
| 90697 |
|
12 |
12 |
$0.00 |
| 90696 |
|
30 |
13 |
$0.00 |