| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
77 |
73 |
$5K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
25 |
24 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
12 |
12 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
258 |
258 |
$432.40 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
62 |
62 |
$159.72 |
| 90686 |
|
34 |
34 |
$80.20 |
| 90698 |
|
24 |
24 |
$0.00 |