| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
847 |
836 |
$26K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,105 |
1,020 |
$22K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
312 |
302 |
$9K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
580 |
577 |
$9K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
136 |
136 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
157 |
152 |
$4K |
| 92552 |
|
129 |
123 |
$1K |
| 86580 |
|
179 |
174 |
$943.39 |
| 85018 |
|
204 |
199 |
$406.35 |
| 99173 |
|
108 |
105 |
$270.64 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
330 |
204 |
$262.57 |
| 81003 |
|
162 |
155 |
$215.81 |
| 86403 |
|
12 |
12 |
$88.02 |
| 90649 |
|
80 |
74 |
$36.00 |
| 90700 |
|
13 |
13 |
$9.00 |
| 90713 |
|
12 |
12 |
$9.00 |
| 90715 |
|
38 |
37 |
$9.00 |
| 90734 |
|
26 |
26 |
$9.00 |
| 90657 |
|
257 |
243 |
$0.00 |