| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,529 |
3,233 |
$197K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,697 |
3,506 |
$57K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
546 |
544 |
$35K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
360 |
358 |
$23K |
| 92551 |
|
1,828 |
1,816 |
$14K |
| 97802 |
|
423 |
419 |
$5K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
77 |
77 |
$3K |
| 99401 |
|
271 |
268 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
27 |
27 |
$2K |
| 90686 |
|
1,110 |
1,103 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
14 |
14 |
$993.76 |
| 99383 |
|
202 |
80 |
$544.03 |
| 90656 |
|
71 |
71 |
$435.95 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
25 |
25 |
$375.27 |
| 99382 |
|
13 |
13 |
$224.90 |
| 90461 |
|
14 |
13 |
$203.27 |
| 90658 |
|
14 |
14 |
$105.51 |
| 90688 |
|
30 |
29 |
$65.42 |
| 90744 |
|
12 |
12 |
$0.00 |
| 90651 |
|
12 |
12 |
$0.00 |
| 90734 |
|
15 |
15 |
$0.00 |