| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
53 |
50 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
35 |
35 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
17 |
16 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
13 |
13 |
$1K |
| 90461 |
|
33 |
33 |
$722.49 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
41 |
41 |
$566.77 |
| 96127 |
|
49 |
49 |
$416.12 |
| 92551 |
|
45 |
45 |
$17.50 |