| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
82 |
76 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
52 |
52 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
18 |
18 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
14 |
14 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
13 |
13 |
$369.70 |
| 94760 |
|
167 |
159 |
$258.39 |
| 99070 |
|
17 |
17 |
$77.00 |
| 99173 |
|
26 |
26 |
$0.00 |
| 90670 |
|
17 |
17 |
$0.00 |
| 90698 |
|
19 |
19 |
$0.00 |