| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
20 |
20 |
$740.40 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
12 |
12 |
$520.92 |
| 92551 |
|
17 |
17 |
$171.70 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
39 |
39 |
$39.77 |
| 85018 |
|
19 |
19 |
$19.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
14 |
14 |
$0.00 |