| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,098 |
1,895 |
$178K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
171 |
166 |
$16K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
118 |
114 |
$10K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
261 |
242 |
$9K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
99 |
91 |
$9K |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
25 |
25 |
$8K |
| 99401 |
|
340 |
307 |
$5K |
| 92551 |
|
499 |
450 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
32 |
30 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
15 |
15 |
$1K |
| 99173 |
|
498 |
451 |
$810.52 |
| 90649 |
|
67 |
63 |
$25.00 |
| 90633 |
|
93 |
89 |
$0.00 |
| 90734 |
|
46 |
42 |
$0.00 |
| 90714 |
|
13 |
13 |
$0.00 |