| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,397 |
1,103 |
$87K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
236 |
225 |
$4K |
| 99401 |
|
370 |
369 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
24 |
24 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
13 |
13 |
$1K |
| 92551 |
|
113 |
113 |
$1K |
| 90686 |
|
18 |
18 |
$331.38 |
| 90461 |
|
14 |
14 |
$289.20 |
| 96127 |
|
13 |
13 |
$55.72 |
| 99173 |
|
144 |
144 |
$27.84 |