| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
163 |
158 |
$14K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
26 |
25 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
23 |
23 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
152 |
148 |
$291.49 |
| 90670 |
|
25 |
25 |
$279.40 |
| 99174 |
|
40 |
40 |
$251.44 |
| 90461 |
|
62 |
60 |
$225.05 |