| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
262 |
245 |
$1K |
| 90480 |
|
17 |
17 |
$1K |
| 90656 |
|
20 |
20 |
$842.20 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
25 |
25 |
$175.50 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
29 |
27 |
$123.45 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
33 |
33 |
$51.14 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
287 |
125 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
61 |
61 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
27 |
27 |
$0.00 |
| 90461 |
|
94 |
73 |
$0.00 |
| 99173 |
|
84 |
84 |
$0.00 |