| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
29 |
21 |
$624.25 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
91 |
75 |
$578.36 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
49 |
35 |
$300.72 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
31 |
22 |
$242.55 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
26 |
17 |
$239.19 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
16 |
13 |
$213.48 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
27 |
17 |
$144.56 |
| 90670 |
|
22 |
19 |
$0.00 |
| 90648 |
|
23 |
19 |
$0.00 |
| 90723 |
|
17 |
15 |
$0.00 |
| 90680 |
|
15 |
14 |
$0.00 |