| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
123 |
121 |
$9K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
58 |
58 |
$6K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
22 |
22 |
$2K |
| 97802 |
|
72 |
72 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
13 |
13 |
$1K |
| 90461 |
|
46 |
46 |
$819.65 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
62 |
62 |
$807.04 |
| 85018 |
|
118 |
118 |
$241.90 |
| 81003 |
|
68 |
68 |
$131.92 |
| 90670 |
|
12 |
12 |
$0.00 |