| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
381 |
347 |
$24K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
109 |
106 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
14 |
12 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
13 |
12 |
$969.72 |
| 36415 |
Collection of venous blood by venipuncture |
12 |
12 |
$584.85 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
42 |
42 |
$231.51 |
| 90670 |
|
14 |
14 |
$0.00 |