| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
960 |
808 |
$58K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
46 |
46 |
$5K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
45 |
40 |
$4K |
| 90658 |
|
104 |
92 |
$2K |
| 90651 |
|
33 |
29 |
$849.23 |
| 99173 |
|
24 |
24 |
$49.19 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
34 |
31 |
$0.00 |