| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,336 |
2,894 |
$365.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,963 |
2,637 |
$80.18 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
70 |
51 |
$78.76 |
| 81025 |
|
12 |
12 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
504 |
386 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,191 |
1,019 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
116 |
111 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
212 |
154 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
513 |
388 |
$0.00 |
| 81003 |
|
168 |
115 |
$0.00 |
| 69210 |
|
44 |
42 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
16 |
16 |
$0.00 |
| 81000 |
|
46 |
46 |
$0.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
184 |
183 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
35 |
28 |
$0.00 |