| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,738 |
1,501 |
$82K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
205 |
184 |
$15K |
| 90686 |
|
212 |
178 |
$3K |
| 96160 |
|
242 |
216 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
23 |
22 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
20 |
20 |
$2K |
| 90734 |
|
13 |
13 |
$224.37 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
15 |
12 |
$0.00 |
| 1036F |
|
446 |
374 |
$0.00 |