| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
982 |
909 |
$51K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
282 |
259 |
$20K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
13 |
13 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
12 |
12 |
$847.99 |
| 90686 |
|
12 |
12 |
$145.94 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
86 |
73 |
$51.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
19 |
19 |
$17.00 |