| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
160 |
154 |
$10K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
54 |
54 |
$5K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
20 |
20 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
16 |
16 |
$2K |
| 90461 |
|
32 |
32 |
$760.32 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
47 |
47 |
$651.88 |
| 96127 |
|
64 |
63 |
$584.62 |
| 92551 |
|
66 |
66 |
$0.00 |