| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
241 |
227 |
$13K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
45 |
45 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
16 |
16 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
12 |
12 |
$971.72 |
| 90670 |
|
35 |
35 |
$508.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
163 |
161 |
$502.93 |
| 90686 |
|
37 |
36 |
$423.45 |
| 90723 |
|
27 |
25 |
$325.73 |
| 92551 |
|
29 |
29 |
$297.84 |
| 90647 |
|
25 |
25 |
$284.77 |
| 90461 |
|
84 |
84 |
$208.80 |
| 99173 |
|
29 |
29 |
$69.45 |
| 85018 |
|
13 |
13 |
$37.44 |
| 36416 |
|
13 |
13 |
$14.30 |
| 94760 |
|
13 |
13 |
$0.00 |