| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
96 |
94 |
$5K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
15 |
15 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
13 |
12 |
$979.32 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
51 |
50 |
$149.31 |
| 99173 |
|
42 |
41 |
$85.47 |
| 85014 |
|
14 |
14 |
$40.32 |
| 36416 |
|
15 |
15 |
$12.10 |