| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
315 |
263 |
$16K |
| 99215 |
Prolong outpt/office vis |
75 |
61 |
$5K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
131 |
99 |
$5K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
17 |
14 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
20 |
16 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
70 |
58 |
$362.48 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
28 |
16 |
$195.60 |
| 87400 |
|
25 |
23 |
$164.49 |