| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
638 |
634 |
$25K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
362 |
318 |
$22K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
124 |
124 |
$14K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
148 |
146 |
$6K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
54 |
53 |
$5K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
24 |
24 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
25 |
25 |
$2K |
| 96127 |
|
196 |
185 |
$898.89 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
26 |
15 |
$407.10 |
| 90686 |
|
264 |
263 |
$188.40 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
261 |
260 |
$0.00 |
| 90620 |
|
139 |
139 |
$0.00 |
| 90651 |
|
52 |
52 |
$0.00 |
| 90670 |
|
53 |
53 |
$0.00 |
| 90734 |
|
13 |
13 |
$0.00 |