| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
414 |
326 |
$17K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
109 |
79 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
69 |
60 |
$4K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
17 |
12 |
$231.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
22 |
13 |
$91.00 |
| 96127 |
|
36 |
17 |
$79.83 |
| 99173 |
|
56 |
56 |
$0.00 |