| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,222 |
1,059 |
$35K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
725 |
716 |
$13K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
855 |
851 |
$11K |
| 92552 |
|
352 |
352 |
$4K |
| 81000 |
|
278 |
274 |
$1K |
| 99173 |
|
360 |
360 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
14 |
14 |
$571.61 |
| D1206 |
Topical application of fluoride varnish |
30 |
30 |
$567.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
12 |
12 |
$508.36 |
| 90686 |
|
296 |
295 |
$356.29 |