| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
572 |
402 |
$22K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
212 |
162 |
$13K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
426 |
300 |
$4K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
71 |
53 |
$4K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
103 |
87 |
$2K |
| 92551 |
|
13 |
12 |
$107.51 |
| 90686 |
|
105 |
81 |
$38.39 |
| 81002 |
|
19 |
15 |
$27.94 |
| 99173 |
|
15 |
12 |
$25.91 |
| 3008F |
|
45 |
38 |
$0.00 |