| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
61 |
58 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
23 |
23 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
20 |
20 |
$995.01 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
16 |
16 |
$404.06 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
23 |
23 |
$259.70 |
| 85018 |
|
27 |
27 |
$37.34 |
| 99173 |
|
14 |
14 |
$0.00 |