| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,528 |
3,756 |
$204K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
176 |
164 |
$13K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
92 |
67 |
$8K |
| 90686 |
|
322 |
282 |
$4K |
| 96160 |
|
82 |
78 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
12 |
12 |
$922.08 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
63 |
42 |
$0.00 |