| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,162 |
1,144 |
$35K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
237 |
231 |
$13K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
103 |
103 |
$6K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
64 |
64 |
$4K |
| 97802 |
|
670 |
668 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
13 |
13 |
$920.14 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
14 |
14 |
$862.61 |
| 92551 |
|
235 |
235 |
$744.84 |
| 90686 |
|
294 |
286 |
$18.82 |
| 99401 |
|
480 |
479 |
$0.00 |
| 99173 |
|
245 |
245 |
$0.00 |
| 90461 |
|
264 |
263 |
$0.00 |
| 90734 |
|
26 |
26 |
$0.00 |
| 90710 |
|
13 |
13 |
$0.00 |
| 90715 |
|
24 |
24 |
$0.00 |
| 90685 |
|
18 |
18 |
$0.00 |
| 90672 |
|
25 |
25 |
$0.00 |
| 90670 |
|
14 |
14 |
$0.00 |
| 90651 |
|
12 |
12 |
$0.00 |