| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,107 |
1,038 |
$87K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,099 |
1,008 |
$55K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
635 |
540 |
$44K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
407 |
361 |
$32K |
| 90686 |
|
258 |
240 |
$4K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
49 |
47 |
$4K |
| 90670 |
|
186 |
165 |
$3K |
| 90677 |
|
107 |
99 |
$2K |
| 90680 |
|
135 |
109 |
$2K |
| 90697 |
|
106 |
97 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$984.25 |
| 90656 |
|
45 |
41 |
$757.45 |
| 90698 |
|
52 |
33 |
$742.12 |
| 87430 |
|
32 |
28 |
$476.94 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
15 |
13 |
$393.22 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
318 |
272 |
$0.00 |
| 90461 |
|
45 |
39 |
$0.00 |