| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
15,709 |
12,054 |
$760K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,133 |
2,864 |
$228K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
501 |
477 |
$38K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
270 |
268 |
$23K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
241 |
234 |
$21K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
140 |
134 |
$11K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
71 |
70 |
$6K |
| 99383 |
|
22 |
22 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
25 |
25 |
$2K |
| 90734 |
|
88 |
73 |
$1K |
| 90686 |
|
48 |
47 |
$599.31 |
| 90715 |
|
15 |
12 |
$246.50 |
| 90710 |
|
12 |
12 |
$200.52 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
190 |
165 |
$129.44 |
| 90461 |
|
13 |
13 |
$0.00 |