| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
172 |
161 |
$12K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
48 |
48 |
$5K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
46 |
46 |
$5K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
31 |
31 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
98 |
98 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
17 |
17 |
$2K |
| 90461 |
|
38 |
38 |
$1K |
| 81002 |
|
128 |
127 |
$346.88 |
| 85018 |
|
168 |
168 |
$340.30 |
| 96127 |
|
17 |
17 |
$120.87 |
| 90686 |
|
18 |
18 |
$16.42 |
| 92552 |
|
125 |
125 |
$0.00 |
| 90633 |
|
16 |
16 |
$0.00 |