| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
389 |
389 |
$15K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,422 |
685 |
$11K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
317 |
317 |
$11K |
| 92552 |
|
729 |
723 |
$7K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
73 |
72 |
$3K |
| 99173 |
|
723 |
722 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
489 |
472 |
$0.00 |
| 3078F |
|
12 |
12 |
$0.00 |
| 90461 |
|
269 |
214 |
$0.00 |
| 90707 |
|
14 |
14 |
$0.00 |
| 90686 |
|
269 |
269 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,913 |
1,708 |
$0.00 |
| 3074F |
|
27 |
27 |
$0.00 |