| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,146 |
1,029 |
$22K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
338 |
325 |
$8K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
268 |
262 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
120 |
120 |
$2K |
| 90686 |
|
405 |
399 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
26 |
26 |
$919.12 |
| 90700 |
|
112 |
112 |
$494.00 |
| 90685 |
|
37 |
35 |
$295.00 |
| 90713 |
|
55 |
55 |
$208.00 |
| 90633 |
|
43 |
42 |
$153.00 |
| 90648 |
|
28 |
27 |
$135.00 |
| 90651 |
|
25 |
25 |
$90.00 |
| 90734 |
|
33 |
33 |
$81.00 |
| 90716 |
|
12 |
12 |
$77.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
173 |
142 |
$0.00 |