| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
127 |
100 |
$8K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
224 |
224 |
$5K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
115 |
115 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
32 |
27 |
$3K |
| 90715 |
|
158 |
158 |
$2K |
| 90480 |
|
56 |
56 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
16 |
16 |
$1K |
| 90686 |
|
141 |
141 |
$1K |
| 0072A |
|
20 |
20 |
$800.00 |
| 0071A |
|
19 |
19 |
$760.00 |
| 90713 |
|
74 |
74 |
$625.74 |
| 90716 |
|
30 |
30 |
$314.96 |
| 90651 |
|
58 |
58 |
$237.31 |
| 91321 |
|
47 |
47 |
$143.44 |
| 90619 |
|
17 |
17 |
$78.68 |
| 90633 |
|
22 |
22 |
$57.64 |
| 90710 |
|
13 |
13 |
$51.13 |
| 99072 |
|
48 |
44 |
$0.00 |
| 91307 |
|
43 |
42 |
$0.00 |