| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
82 |
76 |
$4K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
54 |
54 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
47 |
47 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
28 |
28 |
$2K |
| 90461 |
|
64 |
64 |
$1K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
78 |
78 |
$810.42 |
| 90670 |
|
31 |
31 |
$0.00 |
| 90698 |
|
30 |
30 |
$0.00 |