| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
528 |
453 |
$43K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
760 |
614 |
$42K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
344 |
338 |
$13K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
55 |
55 |
$5K |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
14 |
13 |
$4K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
13 |
13 |
$1K |
| 95117 |
|
60 |
26 |
$513.22 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
16 |
12 |
$308.01 |
| 90686 |
|
19 |
18 |
$0.00 |