| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,298 |
1,197 |
$44K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
206 |
203 |
$17K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
66 |
66 |
$6K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
163 |
113 |
$1K |
| S8301 |
Infection control supplies, not otherwise specified |
186 |
182 |
$950.88 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
12 |
12 |
$475.74 |
| 90686 |
|
14 |
14 |
$0.00 |