| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99215 |
Prolong outpt/office vis |
436 |
345 |
$56K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
818 |
772 |
$26K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
195 |
165 |
$16K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
259 |
237 |
$16K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
40 |
37 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
26 |
25 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
15 |
15 |
$1K |
| 90686 |
|
342 |
323 |
$734.05 |
| 94760 |
|
25 |
20 |
$58.80 |
| 90685 |
|
24 |
19 |
$0.02 |
| 90461 |
|
44 |
38 |
$0.00 |
| 90670 |
|
12 |
12 |
$0.00 |