| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
102 |
98 |
$8K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
66 |
64 |
$7K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
58 |
58 |
$6K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
16 |
16 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
112 |
111 |
$1K |
| 90461 |
|
41 |
41 |
$1K |
| 85018 |
|
103 |
103 |
$211.15 |
| 90686 |
|
38 |
36 |
$0.00 |