| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
492 |
456 |
$18K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
25 |
25 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
13 |
13 |
$588.50 |
| 96160 |
|
75 |
74 |
$253.04 |
| 92551 |
|
12 |
12 |
$40.40 |
| 94760 |
|
16 |
15 |
$34.88 |
| 99173 |
|
13 |
13 |
$13.20 |
| 90461 |
|
13 |
13 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
16 |
16 |
$0.00 |