| Code | Description | Claims | Beneficiaries | Total Paid |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,363 |
1,208 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
68 |
68 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
517 |
510 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
50 |
50 |
$2K |
| 92552 |
|
167 |
166 |
$1K |
| 85018 |
|
513 |
505 |
$960.64 |
| 99173 |
|
309 |
307 |
$605.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
71 |
68 |
$509.04 |
| 81003 |
|
200 |
197 |
$438.46 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
13 |
12 |
$251.10 |
| 90686 |
|
69 |
68 |
$114.36 |
| 97802 |
|
15 |
15 |
$25.95 |
| 90651 |
|
12 |
12 |
$0.00 |