| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,781 |
2,370 |
$81K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
438 |
385 |
$17K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
438 |
142 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
23 |
13 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
15 |
12 |
$964.89 |
| 90461 |
|
27 |
14 |
$85.04 |
| 90649 |
|
27 |
12 |
$0.00 |
| 90658 |
|
14 |
14 |
$0.00 |