| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,660 |
2,394 |
$244K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
184 |
180 |
$4K |
| 36410 |
|
202 |
198 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
29 |
29 |
$2K |
| 90658 |
|
86 |
84 |
$959.69 |
| 92081 |
|
32 |
31 |
$890.56 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
12 |
12 |
$153.90 |
| 90686 |
|
58 |
58 |
$58.92 |