| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
773 |
695 |
$48K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
407 |
383 |
$37K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
221 |
220 |
$20K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
120 |
120 |
$12K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
596 |
593 |
$9K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
290 |
290 |
$9K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
98 |
96 |
$8K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
87 |
87 |
$8K |
| 90674 |
|
42 |
42 |
$1.00 |
| 90670 |
|
57 |
57 |
$0.00 |
| 90658 |
|
16 |
16 |
$0.00 |
| 90686 |
|
27 |
27 |
$0.00 |