| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
552 |
474 |
$33K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
179 |
172 |
$7K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
478 |
218 |
$6K |
| 92588 |
|
243 |
224 |
$6K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
66 |
64 |
$4K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
42 |
40 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
14 |
13 |
$766.61 |
| 99173 |
|
219 |
202 |
$447.36 |
| 81002 |
|
208 |
192 |
$428.70 |
| 90658 |
|
27 |
25 |
$10.91 |
| 90733 |
|
40 |
37 |
$0.00 |