| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
634 |
474 |
$27K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
102 |
71 |
$4K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
40 |
28 |
$1K |
| 90686 |
|
33 |
30 |
$308.00 |
| 90670 |
|
19 |
13 |
$143.00 |
| 90698 |
|
17 |
12 |
$132.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
39 |
26 |
$3.40 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
13 |
12 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
74 |
60 |
$0.00 |