| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
903 |
856 |
$53K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,373 |
1,284 |
$52K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
519 |
493 |
$14K |
| T1017 |
Targeted case management, each 15 minutes |
22 |
13 |
$951.25 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
69 |
69 |
$593.36 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
79 |
78 |
$576.74 |
| 90480 |
|
12 |
12 |
$146.19 |
| 99177 |
|
13 |
13 |
$53.20 |