| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,098 |
1,083 |
$34K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
381 |
365 |
$23K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
111 |
111 |
$7K |
| 92551 |
|
235 |
231 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
17 |
17 |
$1K |
| 90461 |
|
267 |
262 |
$264.92 |
| 99173 |
|
297 |
293 |
$0.00 |
| 99401 |
|
501 |
490 |
$0.00 |
| 90685 |
|
45 |
45 |
$0.00 |
| 90710 |
|
16 |
16 |
$0.00 |
| 90672 |
|
85 |
85 |
$0.00 |
| 90715 |
|
15 |
15 |
$0.00 |
| 90633 |
|
12 |
12 |
$0.00 |
| 90670 |
|
12 |
12 |
$0.00 |
| 90734 |
|
19 |
19 |
$0.00 |
| 90686 |
|
424 |
419 |
$0.00 |
| 97802 |
|
664 |
654 |
$0.00 |
| 90696 |
|
18 |
18 |
$0.00 |
| 90651 |
|
52 |
52 |
$0.00 |