| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
488 |
455 |
$30K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
339 |
310 |
$30K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
641 |
629 |
$19K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
182 |
181 |
$10K |
| 90461 |
|
173 |
172 |
$7K |
| 99177 |
|
41 |
40 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
46 |
46 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
31 |
31 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
14 |
14 |
$702.00 |
| 92551 |
|
28 |
28 |
$331.10 |
| 99173 |
|
59 |
59 |
$160.65 |
| 90685 |
|
78 |
78 |
$0.00 |
| 90670 |
|
17 |
17 |
$0.00 |
| 90698 |
|
31 |
31 |
$0.00 |
| 90686 |
|
129 |
129 |
$0.00 |