| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,418 |
2,095 |
$129K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
164 |
155 |
$10K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
148 |
143 |
$9K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
118 |
115 |
$8K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
232 |
224 |
$8K |
| 90688 |
|
153 |
149 |
$2K |
| 90670 |
|
118 |
113 |
$2K |
| 90686 |
|
127 |
126 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
16 |
16 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
12 |
12 |
$987.68 |
| 90687 |
|
56 |
52 |
$586.86 |
| 90680 |
|
43 |
41 |
$545.00 |
| 90651 |
|
18 |
18 |
$396.00 |
| 90633 |
|
12 |
12 |
$174.06 |
| 90648 |
|
15 |
15 |
$169.75 |
| 90715 |
|
13 |
13 |
$163.66 |
| 90698 |
|
12 |
12 |
$132.00 |
| 99051 |
|
19 |
16 |
$80.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
16 |
14 |
$22.50 |
| 91307 |
|
21 |
21 |
$0.21 |