| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
223 |
201 |
$15K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
201 |
192 |
$9K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
35 |
26 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
17 |
13 |
$266.66 |
| 90670 |
|
27 |
27 |
$0.00 |
| 90686 |
|
34 |
29 |
$0.00 |