| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
956 |
824 |
$28K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
154 |
152 |
$7K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
140 |
136 |
$5K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
107 |
101 |
$4K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
927 |
894 |
$4K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
27 |
25 |
$2K |
| 99383 |
|
12 |
12 |
$170.16 |
| 90686 |
|
195 |
188 |
$96.45 |
| 99050 |
|
15 |
15 |
$15.14 |
| 90633 |
|
12 |
12 |
$0.00 |