| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,175 |
1,014 |
$49K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
319 |
288 |
$20K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,349 |
1,244 |
$19K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
273 |
260 |
$15K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
170 |
163 |
$10K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
120 |
111 |
$7K |
| 90686 |
|
295 |
274 |
$1K |
| 90672 |
|
187 |
176 |
$170.00 |
| 90461 |
|
744 |
374 |
$135.00 |
| 90649 |
|
27 |
27 |
$50.00 |
| 90685 |
|
14 |
12 |
$40.00 |
| 90651 |
|
18 |
13 |
$0.00 |