| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
460 |
422 |
$22K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
193 |
169 |
$13K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
212 |
207 |
$6K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
17 |
13 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
15 |
15 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
14 |
14 |
$1K |
| 92551 |
|
59 |
59 |
$435.88 |
| 99173 |
|
31 |
31 |
$59.00 |
| 90686 |
|
15 |
15 |
$53.52 |
| 81002 |
|
13 |
13 |
$34.46 |
| 94760 |
|
14 |
12 |
$11.72 |