| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
308 |
306 |
$12K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
38 |
38 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
337 |
337 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
12 |
12 |
$1K |
| 90688 |
|
96 |
96 |
$909.84 |
| 99173 |
|
13 |
13 |
$420.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
26 |
26 |
$177.82 |
| 90686 |
|
49 |
49 |
$38.06 |
| 81025 |
|
14 |
13 |
$22.10 |
| 3008F |
|
160 |
160 |
$0.00 |
| 2014F |
|
45 |
45 |
$0.00 |