| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
371 |
347 |
$9K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
143 |
128 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$840.60 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
20 |
13 |
$156.80 |
| 99318 |
|
12 |
12 |
$24.45 |
| 96160 |
|
31 |
15 |
$14.98 |
| 99173 |
|
13 |
13 |
$0.00 |
| 99309 |
Subsequent nursing facility care, per day, low to moderate complexity |
12 |
12 |
$0.00 |