| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
84 |
82 |
$6K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
28 |
28 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
23 |
22 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
17 |
17 |
$2K |
| 90461 |
|
32 |
32 |
$668.33 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
38 |
38 |
$479.18 |
| 96127 |
|
14 |
14 |
$99.54 |