| Code | Description | Claims | Beneficiaries | Total Paid |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
80 |
66 |
$0.00 |
| 92551 |
|
27 |
19 |
$0.00 |
| 99173 |
|
30 |
20 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
110 |
39 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
17 |
12 |
$0.00 |
| 90461 |
|
103 |
32 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
40 |
31 |
$0.00 |