| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,172 |
446 |
$38K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
167 |
52 |
$10K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
185 |
42 |
$9K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
67 |
17 |
$5K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
76 |
14 |
$4K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
638 |
247 |
$976.14 |
| 99188 |
|
41 |
12 |
$73.28 |
| 90687 |
|
16 |
14 |
$0.00 |
| 90670 |
|
81 |
22 |
$0.00 |
| 90680 |
|
44 |
14 |
$0.00 |
| 90686 |
|
143 |
21 |
$0.00 |
| 90723 |
|
60 |
16 |
$0.00 |