| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
622 |
538 |
$24K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
733 |
647 |
$19K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
106 |
85 |
$5K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$720.84 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
23 |
12 |
$229.54 |
| 81002 |
|
25 |
25 |
$68.50 |
| 90700 |
|
12 |
12 |
$0.00 |