| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
212 |
183 |
$17K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
171 |
168 |
$8K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
94 |
83 |
$7K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
91 |
71 |
$6K |
| 90686 |
|
105 |
101 |
$1K |
| 90656 |
|
25 |
25 |
$421.25 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
21 |
17 |
$0.00 |