| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,159 |
982 |
$23K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
254 |
244 |
$13K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
176 |
176 |
$9K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
25 |
24 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
152 |
152 |
$96.00 |
| 90723 |
|
12 |
12 |
$0.00 |
| 90647 |
|
14 |
14 |
$0.00 |
| 90670 |
|
30 |
30 |
$0.00 |