| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
369 |
354 |
$29K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
162 |
162 |
$15K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
278 |
278 |
$10K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
104 |
103 |
$9K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
92 |
92 |
$8K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
56 |
56 |
$6K |
| 99460 |
|
53 |
53 |
$5K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
47 |
47 |
$4K |
| 88738 |
|
300 |
300 |
$1K |
| 99173 |
|
198 |
198 |
$528.75 |
| 83655 |
|
30 |
30 |
$323.10 |
| 85018 |
|
14 |
14 |
$29.54 |
| 90671 |
|
80 |
80 |
$1.00 |
| 90723 |
|
39 |
39 |
$0.00 |
| 90647 |
|
44 |
44 |
$0.00 |
| 96160 |
|
199 |
199 |
$0.00 |
| 90633 |
|
19 |
19 |
$0.00 |