| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
57 |
54 |
$5K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$990.36 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
56 |
56 |
$565.04 |
| 90461 |
|
31 |
31 |
$474.23 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
13 |
13 |
$70.07 |
| 97802 |
|
45 |
45 |
$0.00 |
| S9451 |
Exercise classes, non-physician provider, per session |
55 |
55 |
$0.00 |