| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
365 |
360 |
$16K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
133 |
133 |
$11K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
711 |
710 |
$9K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
121 |
119 |
$8K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
100 |
100 |
$7K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
73 |
73 |
$6K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
386 |
383 |
$5K |
| 90670 |
|
105 |
105 |
$674.10 |
| 90698 |
|
85 |
85 |
$460.00 |
| 90474 |
|
50 |
50 |
$321.92 |
| 90633 |
|
15 |
15 |
$257.60 |
| 90680 |
|
52 |
51 |
$235.52 |
| 96161 |
|
18 |
17 |
$53.25 |
| 90686 |
|
189 |
189 |
$32.73 |
| 3008F |
|
398 |
398 |
$0.00 |
| 2014F |
|
102 |
102 |
$0.00 |
| 90685 |
|
18 |
18 |
$0.00 |