| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
95 |
90 |
$5K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
27 |
27 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
15 |
15 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
14 |
14 |
$999.63 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
26 |
26 |
$792.16 |
| 90461 |
|
22 |
22 |
$505.02 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
30 |
30 |
$346.85 |