| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,472 |
1,335 |
$86K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
391 |
364 |
$33K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
60 |
60 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
12 |
12 |
$1K |
| 94760 |
|
449 |
421 |
$1K |
| 90686 |
|
207 |
205 |
$815.40 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
35 |
35 |
$652.11 |
| 99173 |
|
42 |
42 |
$195.00 |
| 96127 |
|
32 |
24 |
$109.72 |