| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
260 |
242 |
$17K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
337 |
327 |
$14K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
480 |
234 |
$7K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
46 |
46 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
31 |
31 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
12 |
12 |
$321.40 |
| 99173 |
|
57 |
54 |
$113.08 |
| 90686 |
|
15 |
14 |
$0.13 |
| 90697 |
|
27 |
27 |
$0.00 |
| 90677 |
|
72 |
71 |
$0.00 |
| 90680 |
|
15 |
15 |
$0.00 |
| 90656 |
|
41 |
41 |
$0.00 |