| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,147 |
4,273 |
$248K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,512 |
3,813 |
$153K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
766 |
720 |
$56K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
643 |
600 |
$46K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
498 |
431 |
$33K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,616 |
1,377 |
$21K |
| 97802 |
|
855 |
764 |
$19K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
194 |
165 |
$13K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
70 |
66 |
$7K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
18 |
17 |
$250.00 |
| 90670 |
|
101 |
73 |
$70.00 |
| 90716 |
|
22 |
14 |
$0.00 |
| 90680 |
|
25 |
25 |
$0.00 |
| 90648 |
|
13 |
12 |
$0.00 |
| 90715 |
|
15 |
12 |
$0.00 |
| 90707 |
|
23 |
15 |
$0.00 |
| 90700 |
|
25 |
17 |
$0.00 |