| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
253 |
234 |
$20K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
124 |
118 |
$14K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
61 |
61 |
$6K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
240 |
240 |
$5K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
30 |
30 |
$3K |
| 92551 |
|
179 |
179 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
13 |
13 |
$1K |
| 99173 |
|
206 |
206 |
$788.62 |
| 90461 |
|
37 |
37 |
$573.32 |
| 96127 |
|
36 |
36 |
$166.02 |
| 90686 |
|
22 |
22 |
$51.35 |
| G9920 |
Screening performed and negative |
169 |
169 |
$0.31 |