| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
575 |
487 |
$13K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
259 |
175 |
$7K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
197 |
120 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
109 |
106 |
$1K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
93 |
90 |
$933.80 |
| 90715 |
|
35 |
35 |
$698.40 |
| 90619 |
|
31 |
31 |
$605.28 |
| 90633 |
|
24 |
24 |
$535.44 |
| 90651 |
|
27 |
27 |
$512.16 |
| 90710 |
|
16 |
12 |
$372.48 |
| 81025 |
|
90 |
45 |
$129.96 |
| 87210 |
|
46 |
17 |
$50.93 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
25 |
17 |
$0.00 |