| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
11,551 |
9,480 |
$627K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
825 |
819 |
$46K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
275 |
271 |
$27K |
| 92551 |
|
2,104 |
2,095 |
$27K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
399 |
395 |
$27K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
273 |
271 |
$13K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
251 |
235 |
$8K |
| 99188 |
|
358 |
356 |
$8K |
| 90686 |
|
840 |
838 |
$7K |
| 90672 |
|
244 |
244 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
13 |
12 |
$652.98 |
| 90651 |
|
71 |
70 |
$619.00 |
| 90674 |
|
91 |
88 |
$527.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
25 |
25 |
$325.51 |
| 90734 |
|
29 |
29 |
$245.00 |
| 90649 |
|
31 |
31 |
$220.00 |
| 90633 |
|
26 |
25 |
$200.00 |
| 90716 |
|
14 |
14 |
$130.00 |
| 90670 |
|
13 |
13 |
$129.00 |
| 90648 |
|
13 |
13 |
$129.00 |
| 90707 |
|
14 |
14 |
$120.00 |
| 90685 |
|
12 |
12 |
$120.00 |
| 90715 |
|
12 |
12 |
$90.00 |