| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
419 |
384 |
$24K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
242 |
240 |
$12K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
318 |
296 |
$12K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
161 |
158 |
$10K |
| 90461 |
|
158 |
158 |
$8K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
134 |
132 |
$8K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
28 |
28 |
$2K |
| 99173 |
|
120 |
113 |
$4.98 |
| 90648 |
|
29 |
29 |
$0.00 |
| 90670 |
|
19 |
19 |
$0.00 |