| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
61 |
55 |
$6K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
74 |
70 |
$5K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
45 |
45 |
$5K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
15 |
15 |
$1K |
| 90461 |
|
39 |
39 |
$832.26 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
53 |
53 |
$668.33 |
| 99188 |
|
14 |
14 |
$226.80 |
| 96127 |
|
31 |
29 |
$213.30 |
| 99174 |
|
31 |
31 |
$168.95 |
| 85018 |
|
12 |
12 |
$24.60 |
| 90648 |
|
15 |
15 |
$0.00 |
| 90633 |
|
25 |
25 |
$0.00 |
| 90670 |
|
15 |
15 |
$0.00 |