| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,076 |
5,409 |
$209K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,087 |
1,898 |
$95K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
617 |
602 |
$8K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
119 |
112 |
$1K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
14 |
12 |
$994.51 |
| 90686 |
|
127 |
122 |
$925.00 |
| 90674 |
|
15 |
15 |
$308.00 |
| 90756 |
|
13 |
13 |
$256.50 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
13 |
13 |
$206.43 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
15 |
13 |
$105.60 |
| 3008F |
|
408 |
362 |
$0.00 |
| 90656 |
|
12 |
12 |
$0.00 |