| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
360 |
254 |
$21K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
141 |
122 |
$6K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
25 |
24 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$1K |
| 90686 |
|
57 |
48 |
$1K |
| 0072A |
|
12 |
12 |
$480.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
36 |
14 |
$109.35 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
449 |
414 |
$105.29 |
| 99173 |
|
46 |
40 |
$95.56 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
132 |
113 |
$93.94 |
| 96127 |
|
19 |
14 |
$61.23 |
| 81002 |
|
72 |
64 |
$25.41 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
78 |
78 |
$0.00 |