| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
198 |
198 |
$18K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
219 |
214 |
$17K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
25 |
25 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
122 |
122 |
$1K |
| 90686 |
|
54 |
54 |
$1K |
| 90658 |
|
17 |
17 |
$317.36 |
| 90688 |
|
12 |
12 |
$248.38 |
| 99080 |
|
24 |
24 |
$0.00 |