| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,170 |
2,352 |
$206K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
886 |
808 |
$19K |
| 96112 |
|
242 |
240 |
$13K |
| 92551 |
|
313 |
312 |
$3K |
| 96111 |
|
26 |
26 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
27 |
27 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
13 |
13 |
$1K |
| 90461 |
|
34 |
29 |
$881.14 |
| 99173 |
|
148 |
147 |
$202.50 |
| 90656 |
|
55 |
55 |
$111.76 |
| 96127 |
|
29 |
29 |
$55.35 |
| 90686 |
|
208 |
208 |
$39.37 |
| 91300 |
|
16 |
16 |
$0.00 |
| 90688 |
|
18 |
18 |
$0.00 |