| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
381 |
356 |
$21K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
552 |
480 |
$20K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
56 |
55 |
$5K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
40 |
40 |
$4K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
295 |
266 |
$2K |
| 99215 |
Prolong outpt/office vis |
12 |
12 |
$741.76 |
| 97802 |
|
210 |
207 |
$0.00 |
| 90686 |
|
28 |
27 |
$0.00 |
| 99173 |
|
186 |
183 |
$0.00 |
| 90670 |
|
12 |
12 |
$0.00 |
| 90461 |
|
48 |
48 |
$0.00 |