| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,493 |
1,177 |
$97K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,243 |
992 |
$50K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,584 |
1,293 |
$30K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
60 |
60 |
$6K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
50 |
40 |
$4K |
| 99460 |
|
17 |
12 |
$306.54 |
| 99174 |
|
30 |
24 |
$240.00 |
| 99050 |
|
17 |
12 |
$103.76 |
| 90656 |
|
38 |
26 |
$19.25 |
| 90686 |
|
682 |
601 |
$19.03 |
| 85018 |
|
105 |
76 |
$9.04 |
| 81002 |
|
31 |
25 |
$2.44 |