| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
679 |
604 |
$34K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
690 |
664 |
$11K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
67 |
67 |
$4K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
13 |
13 |
$907.49 |
| 99441 |
|
14 |
12 |
$309.60 |
| 81002 |
|
102 |
102 |
$165.10 |
| 99173 |
|
103 |
103 |
$50.87 |
| 90656 |
|
87 |
87 |
$21.41 |