| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
172 |
127 |
$7K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
456 |
136 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
42 |
31 |
$3K |
| 99215 |
Prolong outpt/office vis |
32 |
21 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
18 |
14 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
25 |
14 |
$1K |
| 90461 |
|
99 |
62 |
$612.68 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
15 |
15 |
$121.53 |
| 99000 |
|
25 |
15 |
$65.66 |
| 99173 |
|
14 |
12 |
$0.00 |
| 90670 |
|
23 |
12 |
$0.00 |
| 90686 |
|
90 |
72 |
$0.00 |
| 36416 |
|
21 |
12 |
$0.00 |