| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,299 |
1,022 |
$69K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,791 |
1,354 |
$50K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
123 |
104 |
$9K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
70 |
68 |
$6K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$1K |
| 90461 |
|
138 |
101 |
$46.50 |
| 90655 |
|
28 |
25 |
$0.00 |
| 90648 |
|
14 |
13 |
$0.00 |
| 90670 |
|
15 |
14 |
$0.00 |
| 90686 |
|
129 |
100 |
$0.00 |
| 90656 |
|
71 |
69 |
$0.00 |