| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
977 |
629 |
$67K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
810 |
584 |
$62K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,157 |
919 |
$55K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
526 |
418 |
$43K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
85 |
71 |
$7K |
| 90670 |
|
390 |
253 |
$5K |
| 90686 |
|
585 |
467 |
$5K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
196 |
166 |
$5K |
| 90698 |
|
395 |
256 |
$3K |
| 90680 |
|
129 |
88 |
$1K |
| 90656 |
|
41 |
33 |
$597.28 |
| 99174 |
|
51 |
28 |
$372.31 |
| 90685 |
|
37 |
29 |
$347.90 |
| 90744 |
|
20 |
13 |
$123.50 |
| 90633 |
|
12 |
12 |
$80.64 |
| 90461 |
|
65 |
50 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
867 |
528 |
$0.00 |