| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,360 |
1,270 |
$102K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
392 |
370 |
$43K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
13 |
13 |
$2K |
| 0011A |
|
32 |
32 |
$1K |
| 0012A |
|
28 |
28 |
$953.82 |
| 0013A |
|
20 |
20 |
$782.15 |
| 90686 |
|
24 |
24 |
$302.53 |
| 90688 |
|
15 |
15 |
$178.39 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
25 |
25 |
$167.81 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
12 |
12 |
$139.40 |
| 91301 |
|
72 |
72 |
$0.00 |