| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
757 |
711 |
$57K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
28 |
27 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
12 |
12 |
$1K |
| 90686 |
|
106 |
106 |
$904.74 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
186 |
186 |
$565.91 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
57 |
57 |
$157.90 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
58 |
28 |
$118.94 |