| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
694 |
632 |
$29K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,326 |
705 |
$20K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
142 |
128 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
67 |
63 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
59 |
56 |
$3K |
| 92587 |
|
172 |
165 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
28 |
27 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
28 |
25 |
$1K |
| 92558 |
|
115 |
113 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
13 |
12 |
$899.54 |
| 99173 |
|
237 |
228 |
$507.60 |
| 90633 |
|
26 |
26 |
$67.11 |
| 90686 |
|
157 |
153 |
$10.15 |
| 90651 |
|
12 |
12 |
$0.03 |
| 90685 |
|
15 |
15 |
$0.03 |
| 90698 |
|
13 |
12 |
$0.01 |
| 90670 |
|
14 |
13 |
$0.01 |