| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
687 |
636 |
$35K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
337 |
321 |
$11K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
731 |
713 |
$6K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
42 |
42 |
$4K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
26 |
24 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
13 |
13 |
$1K |
| 92552 |
|
205 |
205 |
$1K |
| 99460 |
|
12 |
12 |
$920.68 |
| 90686 |
|
126 |
126 |
$341.73 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
12 |
12 |
$136.38 |
| 85018 |
|
327 |
324 |
$92.36 |
| 94760 |
|
226 |
216 |
$0.00 |
| 82962 |
|
127 |
125 |
$0.00 |
| 81002 |
|
102 |
101 |
$0.00 |