| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
622 |
544 |
$38K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
141 |
131 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
73 |
73 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$1K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
52 |
51 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
13 |
13 |
$954.07 |
| 99401 |
|
14 |
14 |
$217.63 |
| 81025 |
|
12 |
12 |
$83.76 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
42 |
40 |
$63.07 |
| J1094 |
Injection, dexamethasone acetate, 1 mg |
12 |
12 |
$4.95 |