| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
324 |
292 |
$27K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
260 |
224 |
$16K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
73 |
66 |
$6K |
| 90686 |
|
190 |
179 |
$1K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
39 |
38 |
$818.74 |
| 90672 |
|
26 |
26 |
$707.95 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
118 |
109 |
$0.00 |
| 90473 |
|
14 |
14 |
$0.00 |