| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
198 |
195 |
$11K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
85 |
78 |
$8K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
28 |
28 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
339 |
338 |
$817.96 |
| 90686 |
|
32 |
32 |
$537.59 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
135 |
128 |
$496.02 |
| 90670 |
|
12 |
12 |
$0.00 |
| 90698 |
|
13 |
13 |
$0.00 |