| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
85 |
85 |
$9K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
39 |
39 |
$4K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
35 |
35 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
53 |
51 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
26 |
24 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
25 |
24 |
$2K |
| 90461 |
|
79 |
79 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
118 |
118 |
$1K |
| 96127 |
|
32 |
32 |
$227.52 |
| 3725F |
|
32 |
32 |
$0.00 |
| 90734 |
|
12 |
12 |
$0.00 |
| 90715 |
|
13 |
13 |
$0.00 |
| 90649 |
|
12 |
12 |
$0.00 |