| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
275 |
252 |
$15K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
120 |
115 |
$8K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
356 |
348 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
37 |
37 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
35 |
35 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$936.47 |
| 85018 |
|
295 |
295 |
$721.49 |
| 81000 |
|
189 |
188 |
$573.98 |
| 90461 |
|
122 |
120 |
$0.00 |
| 97802 |
|
26 |
26 |
$0.00 |