| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90686 |
|
33 |
33 |
$647.10 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
532 |
503 |
$143.66 |
| 99442 |
|
12 |
12 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
85 |
85 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
51 |
51 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
83 |
82 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
60 |
59 |
$0.00 |