| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90461 |
|
90 |
88 |
$4K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
40 |
40 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
399 |
340 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
14 |
13 |
$897.86 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
158 |
151 |
$751.67 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
13 |
13 |
$451.02 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
13 |
13 |
$234.93 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
15 |
12 |
$18.60 |
| 92551 |
|
36 |
34 |
$0.00 |
| 90670 |
|
25 |
25 |
$0.00 |
| 99188 |
|
12 |
12 |
$0.00 |