| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90686 |
|
144 |
144 |
$352.35 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
116 |
114 |
$251.86 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
593 |
573 |
$160.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
159 |
159 |
$4.01 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
12 |
12 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
31 |
31 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
42 |
42 |
$0.00 |
| 3078F |
|
131 |
127 |
$0.00 |
| 3080F |
|
34 |
33 |
$0.00 |
| 3008F |
|
260 |
253 |
$0.00 |
| 3074F |
|
199 |
193 |
$0.00 |
| 3079F |
|
60 |
60 |
$0.00 |
| 99385 |
|
28 |
28 |
$0.00 |