| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,487 |
3,297 |
$228K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
929 |
858 |
$68K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
135 |
134 |
$13K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
103 |
103 |
$8K |
| 3008F |
|
373 |
373 |
$4K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
78 |
76 |
$1K |
| 86580 |
|
143 |
143 |
$496.49 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
72 |
72 |
$0.00 |