| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,233 |
3,000 |
$20K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
573 |
566 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
838 |
835 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,176 |
1,981 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
170 |
169 |
$394.46 |
| 99173 |
|
1,610 |
1,595 |
$128.57 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,707 |
1,694 |
$94.38 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
12 |
12 |
$65.52 |
| 99401 |
|
2,873 |
2,606 |
$64.05 |
| 90686 |
|
554 |
552 |
$32.49 |
| 90670 |
|
12 |
12 |
$27.00 |
| 90734 |
|
37 |
37 |
$18.00 |
| 90700 |
|
12 |
12 |
$18.00 |
| 90716 |
|
13 |
13 |
$9.00 |
| 90461 |
|
630 |
630 |
$0.00 |
| 91300 |
|
14 |
14 |
$0.00 |
| 90649 |
|
23 |
23 |
$0.00 |
| 90715 |
|
28 |
28 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
96 |
90 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
14 |
14 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
390 |
389 |
$0.00 |
| 90688 |
|
62 |
62 |
$0.00 |
| 90620 |
|
17 |
17 |
$0.00 |