| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99460 |
|
14 |
14 |
$711.36 |
| 90670 |
|
12 |
12 |
$197.10 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
465 |
400 |
$103.68 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
135 |
131 |
$0.00 |
| 92081 |
|
108 |
107 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
71 |
71 |
$0.00 |
| 90461 |
|
25 |
25 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
15 |
12 |
$0.00 |
| 96160 |
|
62 |
62 |
$0.00 |
| 85018 |
|
89 |
88 |
$0.00 |
| 92551 |
|
109 |
108 |
$0.00 |
| 90686 |
|
12 |
12 |
$0.00 |