| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
360 |
345 |
$18K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
304 |
300 |
$18K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
36 |
36 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
12 |
12 |
$964.60 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
83 |
82 |
$638.02 |
| 90688 |
|
19 |
19 |
$384.62 |
| 90686 |
|
51 |
51 |
$196.43 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
29 |
20 |
$13.81 |
| 99173 |
|
12 |
12 |
$0.00 |