| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,473 |
3,054 |
$253K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
785 |
738 |
$49K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
66 |
66 |
$6K |
| 99215 |
Prolong outpt/office vis |
28 |
24 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
27 |
27 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
386 |
382 |
$326.43 |
| 99173 |
|
164 |
164 |
$259.40 |
| 90461 |
|
26 |
26 |
$0.00 |