| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
120 |
116 |
$9K |
| 99215 |
Prolong outpt/office vis |
25 |
25 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
119 |
119 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$988.80 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
13 |
13 |
$986.31 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
13 |
12 |
$934.21 |
| 92551 |
|
120 |
120 |
$784.17 |
| 90686 |
|
54 |
54 |
$406.21 |
| 81002 |
|
60 |
59 |
$160.43 |
| 96127 |
|
27 |
27 |
$76.19 |
| 99173 |
|
70 |
70 |
$0.00 |