| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,004 |
1,774 |
$97K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
66 |
56 |
$5K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
12 |
12 |
$1K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
129 |
124 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$947.54 |
| 90461 |
|
27 |
26 |
$573.85 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
13 |
12 |
$102.80 |