| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,926 |
2,582 |
$116K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,014 |
1,659 |
$57K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
454 |
395 |
$24K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
422 |
374 |
$21K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
420 |
378 |
$20K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
152 |
129 |
$7K |
| 90649 |
|
344 |
253 |
$987.77 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
12 |
12 |
$757.33 |
| 90658 |
|
257 |
233 |
$423.69 |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
23 |
16 |
$402.98 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
127 |
122 |
$360.89 |
| 90734 |
|
181 |
147 |
$290.00 |
| 90633 |
|
102 |
72 |
$266.00 |
| 90670 |
|
353 |
253 |
$254.00 |
| 90700 |
|
292 |
217 |
$240.00 |
| 90647 |
|
163 |
112 |
$234.00 |
| 90680 |
|
68 |
40 |
$108.00 |
| 90713 |
|
92 |
70 |
$90.00 |
| 90715 |
|
34 |
31 |
$70.00 |
| 90707 |
|
49 |
26 |
$0.00 |
| 90716 |
|
53 |
27 |
$0.00 |
| 90696 |
|
43 |
25 |
$0.00 |
| 90744 |
|
57 |
25 |
$0.00 |