| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,447 |
1,113 |
$106K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,044 |
733 |
$82K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,244 |
951 |
$58K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
581 |
411 |
$41K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
392 |
299 |
$30K |
| 90686 |
|
784 |
632 |
$8K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
46 |
35 |
$4K |
| 90670 |
|
225 |
173 |
$3K |
| 90656 |
|
87 |
82 |
$1K |
| 90698 |
|
137 |
94 |
$891.81 |
| 90677 |
|
31 |
27 |
$519.01 |
| 90680 |
|
28 |
25 |
$317.75 |
| 90697 |
|
14 |
14 |
$237.44 |
| 87430 |
|
13 |
12 |
$206.45 |
| 90685 |
|
18 |
13 |
$203.92 |
| 90744 |
|
22 |
13 |
$143.84 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,281 |
866 |
$0.00 |
| 90461 |
|
154 |
107 |
$0.00 |