| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
308 |
280 |
$22K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
204 |
177 |
$20K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
741 |
685 |
$16K |
| 90461 |
|
427 |
399 |
$8K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
43 |
42 |
$7K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
45 |
40 |
$5K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
31 |
30 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
13 |
13 |
$2K |
| 99242 |
|
12 |
12 |
$2K |
| 99174 |
|
12 |
12 |
$126.60 |
| 90671 |
|
13 |
12 |
$0.00 |
| 90686 |
|
34 |
30 |
$0.00 |
| 90656 |
|
12 |
12 |
$0.00 |