| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
508 |
478 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
50 |
50 |
$310.54 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
81 |
81 |
$249.72 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
490 |
241 |
$221.82 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
51 |
51 |
$108.78 |
| 90461 |
|
636 |
146 |
$49.35 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
51 |
51 |
$0.00 |
| 90670 |
|
55 |
55 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$0.00 |