| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,167 |
2,960 |
$312K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,102 |
1,973 |
$140K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
773 |
771 |
$80K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
646 |
641 |
$66K |
| 90461 |
|
1,446 |
1,442 |
$55K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
474 |
474 |
$49K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,392 |
2,377 |
$48K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
445 |
442 |
$46K |
| 86403 |
|
841 |
822 |
$9K |
| 99215 |
Prolong outpt/office vis |
48 |
45 |
$6K |
| 99381 |
|
35 |
35 |
$6K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
228 |
218 |
$5K |
| 90670 |
|
674 |
670 |
$266.00 |
| 90723 |
|
485 |
485 |
$185.00 |
| 90647 |
|
460 |
459 |
$176.00 |
| 90658 |
|
466 |
465 |
$148.33 |
| 90649 |
|
294 |
292 |
$141.04 |
| 90734 |
|
139 |
138 |
$102.00 |
| 90681 |
|
262 |
262 |
$95.00 |
| 90633 |
|
289 |
287 |
$94.28 |
| 90657 |
|
284 |
282 |
$53.08 |
| 90620 |
|
89 |
89 |
$32.00 |
| 90715 |
|
87 |
87 |
$29.00 |
| 90700 |
|
73 |
73 |
$23.00 |
| 90696 |
|
45 |
45 |
$7.00 |
| 90710 |
|
53 |
53 |
$2.00 |
| 90619 |
|
57 |
57 |
$0.00 |