| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
14 |
14 |
$296.16 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
17 |
17 |
$173.64 |
| 92551 |
|
71 |
71 |
$121.20 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
48 |
48 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
38 |
38 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
106 |
106 |
$0.00 |
| 99173 |
|
77 |
77 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
54 |
54 |
$0.00 |