| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
430 |
407 |
$22K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
276 |
267 |
$20K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
89 |
86 |
$6K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
58 |
57 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
24 |
24 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
12 |
12 |
$800.36 |
| 90688 |
|
62 |
60 |
$654.82 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
13 |
13 |
$436.67 |
| 90670 |
|
28 |
28 |
$401.57 |
| 90686 |
|
29 |
29 |
$319.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
34 |
34 |
$193.27 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
228 |
221 |
$34.00 |
| 90461 |
|
91 |
89 |
$20.40 |