| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
678 |
635 |
$22K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
466 |
187 |
$4K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
97 |
97 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
28 |
28 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
31 |
31 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
30 |
30 |
$1K |
| 69210 |
|
15 |
14 |
$228.01 |
| 90677 |
|
24 |
24 |
$42.50 |