| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
170 |
167 |
$14K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
48 |
48 |
$4K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
29 |
29 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
14 |
14 |
$1K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
74 |
74 |
$933.14 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
14 |
14 |
$773.78 |
| 96127 |
|
57 |
57 |
$409.35 |
| 90461 |
|
18 |
18 |
$327.86 |
| 99401 |
|
44 |
44 |
$0.00 |
| 99173 |
|
97 |
97 |
$0.00 |