| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
532 |
512 |
$35K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
15 |
12 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
12 |
12 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
161 |
161 |
$299.40 |
| 90686 |
|
26 |
26 |
$101.64 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
62 |
62 |
$0.00 |
| 99051 |
|
14 |
12 |
$0.00 |