| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
218 |
198 |
$14K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
50 |
41 |
$4K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
15 |
15 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$1K |
| 90656 |
|
19 |
18 |
$322.49 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
63 |
54 |
$0.00 |
| 1160F |
|
28 |
28 |
$0.00 |
| 1159F |
|
28 |
28 |
$0.00 |