| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,515 |
1,440 |
$95K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
546 |
522 |
$49K |
| 90686 |
|
1,058 |
1,054 |
$14K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
38 |
38 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
109 |
108 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
13 |
13 |
$1K |
| 0071A |
|
27 |
27 |
$1K |
| 0072A |
|
21 |
21 |
$800.00 |
| 99173 |
|
467 |
464 |
$762.37 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
16 |
13 |
$524.65 |
| 90685 |
|
19 |
19 |
$309.13 |
| 81002 |
|
108 |
102 |
$299.83 |
| 90480 |
|
12 |
12 |
$233.20 |
| 90656 |
|
45 |
45 |
$137.63 |
| 90688 |
|
14 |
14 |
$83.44 |
| 90715 |
|
12 |
12 |
$71.52 |
| 96161 |
|
12 |
12 |
$37.62 |
| 99072 |
|
648 |
600 |
$8.00 |
| 91307 |
|
54 |
51 |
$0.00 |