| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
322 |
321 |
$13K |
| 90461 |
|
43 |
43 |
$2K |
| 92551 |
|
79 |
79 |
$724.54 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
13 |
13 |
$715.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
13 |
13 |
$702.28 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
12 |
12 |
$638.89 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
16 |
16 |
$306.63 |
| 90686 |
|
148 |
148 |
$41.10 |
| 3008F |
|
136 |
136 |
$0.00 |
| 1126F |
|
67 |
67 |
$0.00 |
| 99173 |
|
80 |
80 |
$0.00 |