| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
41 |
40 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
44 |
44 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
86 |
85 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
47 |
40 |
$1K |
| 90633 |
|
63 |
62 |
$54.22 |