| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
594 |
467 |
$29K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
228 |
179 |
$13K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
77 |
75 |
$6K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
39 |
38 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
33 |
32 |
$2K |
| 90677 |
|
13 |
12 |
$953.98 |
| 99402 |
|
53 |
51 |
$511.56 |
| 90633 |
|
26 |
26 |
$223.18 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
135 |
98 |
$132.60 |
| 85018 |
|
61 |
58 |
$129.20 |
| 90686 |
|
18 |
13 |
$121.35 |
| 90710 |
|
14 |
14 |
$111.00 |
| 97803 |
|
53 |
51 |
$81.45 |
| 81002 |
|
34 |
29 |
$59.20 |
| 36416 |
|
54 |
54 |
$7.07 |
| 90461 |
|
32 |
25 |
$0.00 |