| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
90 |
86 |
$6K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
84 |
77 |
$4K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
39 |
38 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
321 |
285 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
31 |
25 |
$1K |
| 99000 |
|
100 |
89 |
$993.60 |
| 90461 |
|
136 |
127 |
$806.15 |
| 90686 |
|
72 |
68 |
$0.00 |
| 90670 |
|
72 |
69 |
$0.00 |
| 99188 |
|
15 |
15 |
$0.00 |