| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
511 |
463 |
$40K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
451 |
413 |
$24K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
16 |
16 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
13 |
13 |
$943.68 |
| 90688 |
|
56 |
56 |
$689.26 |
| 92551 |
|
34 |
34 |
$358.19 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
208 |
191 |
$236.34 |
| 85018 |
|
85 |
79 |
$208.91 |
| 81002 |
|
49 |
49 |
$143.17 |
| 99173 |
|
52 |
51 |
$129.69 |
| 36416 |
|
85 |
79 |
$48.65 |