| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
311 |
299 |
$17K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
21 |
21 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
12 |
12 |
$913.16 |
| 90686 |
|
75 |
72 |
$788.68 |
| 92551 |
|
15 |
15 |
$136.20 |
| 99173 |
|
27 |
27 |
$63.19 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
68 |
65 |
$55.18 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
31 |
31 |
$49.59 |
| 99051 |
|
44 |
42 |
$12.00 |