| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
376 |
345 |
$28K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
75 |
73 |
$8K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
16 |
16 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
15 |
15 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
121 |
121 |
$2K |
| 90461 |
|
33 |
33 |
$728.20 |
| 85018 |
|
43 |
43 |
$92.45 |
| 81003 |
|
30 |
30 |
$61.20 |
| 90686 |
|
43 |
43 |
$0.00 |