| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
127 |
110 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
129 |
127 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
13 |
13 |
$216.54 |
| 92551 |
|
56 |
55 |
$176.60 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$0.00 |
| 99173 |
|
15 |
15 |
$0.00 |
| 90686 |
|
13 |
13 |
$0.00 |