| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
381 |
310 |
$14K |
| 90686 |
|
146 |
132 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
44 |
37 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
14 |
13 |
$611.63 |
| 90656 |
|
32 |
32 |
$606.52 |
| 3008F |
|
19 |
18 |
$180.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
35 |
29 |
$0.00 |
| 99177 |
|
24 |
24 |
$0.00 |