| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
129 |
93 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
46 |
42 |
$3K |
| 99382 |
|
45 |
37 |
$2K |
| 99383 |
|
20 |
19 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
32 |
25 |
$1K |
| 90677 |
|
14 |
13 |
$927.09 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
28 |
21 |
$822.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
90 |
70 |
$547.60 |
| 90698 |
|
14 |
13 |
$344.04 |
| 92552 |
|
16 |
15 |
$291.60 |
| 90461 |
|
22 |
20 |
$156.96 |
| 99173 |
|
30 |
29 |
$56.81 |