| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
40 |
40 |
$1K |
| 99215 |
Prolong outpt/office vis |
17 |
17 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
17 |
17 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
13 |
13 |
$827.19 |
| 90723 |
|
13 |
13 |
$378.04 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
24 |
24 |
$307.68 |
| 90686 |
|
43 |
43 |
$244.14 |
| 90670 |
|
28 |
28 |
$161.46 |
| 90647 |
|
27 |
27 |
$154.44 |