| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
85 |
80 |
$8K |
| 99215 |
Prolong outpt/office vis |
40 |
36 |
$5K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
54 |
53 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
19 |
19 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$1K |
| 96127 |
|
77 |
72 |
$699.82 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
31 |
31 |
$438.16 |
| 90461 |
|
13 |
13 |
$288.11 |
| 94664 |
|
13 |
13 |
$164.47 |
| 92551 |
|
50 |
50 |
$0.00 |