| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
878 |
869 |
$49K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
717 |
690 |
$34K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
125 |
117 |
$4K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
392 |
389 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
179 |
179 |
$3K |
| 83655 |
|
12 |
12 |
$1K |
| 90686 |
|
407 |
402 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
13 |
13 |
$966.83 |
| 36416 |
|
12 |
12 |
$861.12 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
15 |
15 |
$839.49 |
| 90633 |
|
12 |
12 |
$0.00 |
| 90648 |
|
30 |
30 |
$0.00 |
| 99188 |
|
17 |
17 |
$0.00 |
| 90670 |
|
30 |
30 |
$0.00 |
| 90651 |
|
12 |
12 |
$0.00 |
| 90723 |
|
13 |
13 |
$0.00 |