| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
141 |
138 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
19 |
18 |
$546.95 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
45 |
45 |
$49.70 |
| 99173 |
|
13 |
13 |
$15.75 |
| 3078F |
|
172 |
165 |
$0.00 |
| T1015 |
Clinic visit/encounter, all-inclusive |
16 |
16 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
14 |
14 |
$0.00 |
| 3074F |
|
178 |
172 |
$0.00 |
| 3079F |
|
28 |
28 |
$0.00 |