| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
293 |
279 |
$17K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
303 |
290 |
$12K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
295 |
287 |
$11K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
42 |
42 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
28 |
28 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
26 |
26 |
$2K |
| 90680 |
|
14 |
14 |
$0.00 |
| 90686 |
|
48 |
48 |
$0.00 |
| 90698 |
|
14 |
14 |
$0.00 |
| 90670 |
|
31 |
31 |
$0.00 |