| Code | Description | Claims | Bene. Records | Total Paid |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
16 |
15 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
21 |
21 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
12 |
12 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
21 |
21 |
$0.00 |