| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
159 |
155 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
421 |
399 |
$2K |
| 96127 |
|
787 |
726 |
$286.90 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
103 |
97 |
$271.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
94 |
92 |
$258.40 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
13 |
13 |
$136.28 |
| 90656 |
|
13 |
13 |
$65.30 |
| 3079F |
|
30 |
30 |
$0.00 |
| 3074F |
|
73 |
69 |
$0.00 |
| 3078F |
|
48 |
44 |
$0.00 |