| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
241 |
177 |
$17K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
84 |
52 |
$6K |
| 90686 |
|
535 |
437 |
$6K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
105 |
98 |
$5K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
39 |
16 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$1K |
| 90651 |
|
21 |
12 |
$573.73 |
| 90656 |
|
32 |
31 |
$543.72 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
421 |
257 |
$0.00 |
| 90461 |
|
17 |
13 |
$0.00 |