| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
50 |
50 |
$2K |
| 90480 |
|
24 |
24 |
$534.24 |
| 90686 |
|
87 |
85 |
$127.80 |
| 90656 |
|
12 |
12 |
$30.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
93 |
91 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
13 |
12 |
$0.00 |
| 99173 |
|
14 |
14 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
280 |
271 |
$0.00 |