| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
689 |
645 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
222 |
221 |
$81.40 |
| 86580 |
|
13 |
13 |
$72.00 |
| 87081 |
|
26 |
26 |
$11.36 |
| 85018 |
|
274 |
272 |
$10.44 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
13 |
13 |
$4.90 |
| 3725F |
|
13 |
13 |
$0.00 |
| 99173 |
|
116 |
116 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
41 |
41 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
13 |
13 |
$0.00 |
| 92551 |
|
100 |
100 |
$0.00 |
| 90686 |
|
20 |
20 |
$0.00 |
| 90688 |
|
18 |
18 |
$0.00 |