| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
324 |
300 |
$58.50 |
| 3725F |
|
211 |
192 |
$0.00 |
| 3078F |
|
181 |
169 |
$0.00 |
| 3077F |
|
63 |
57 |
$0.00 |
| 1158F |
|
16 |
16 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
95 |
85 |
$0.00 |
| 1090F |
|
84 |
74 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
21 |
19 |
$0.00 |
| 4004F |
|
99 |
86 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
25 |
17 |
$0.00 |
| 1159F |
|
16 |
16 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
26 |
24 |
$0.00 |
| 1160F |
|
16 |
16 |
$0.00 |
| 3074F |
|
109 |
104 |
$0.00 |
| 3008F |
|
288 |
267 |
$0.00 |
| 1126F |
|
306 |
283 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
57 |
57 |
$0.00 |
| 1170F |
|
71 |
68 |
$0.00 |
| 96127 |
|
14 |
13 |
$0.00 |
| 1157F |
|
131 |
124 |
$0.00 |
| 1031F |
|
42 |
39 |
$0.00 |
| 90686 |
|
14 |
14 |
$0.00 |