| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
275 |
246 |
$15K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
48 |
45 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
42 |
40 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
26 |
26 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
108 |
102 |
$1K |
| 90461 |
|
20 |
20 |
$371.32 |
| 90686 |
|
39 |
39 |
$364.48 |
| 92551 |
|
29 |
27 |
$230.52 |
| 99173 |
|
26 |
26 |
$54.92 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
12 |
12 |
$0.00 |