| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
190 |
184 |
$16K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
129 |
127 |
$7K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
33 |
33 |
$3K |
| 90461 |
|
92 |
92 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
152 |
152 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
16 |
16 |
$1K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
30 |
29 |
$161.70 |
| 97802 |
|
69 |
69 |
$0.00 |
| 90686 |
|
32 |
32 |
$0.00 |
| S9451 |
Exercise classes, non-physician provider, per session |
87 |
87 |
$0.00 |