| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92551 |
|
563 |
563 |
$6K |
| 99000 |
|
742 |
739 |
$3K |
| 0072A |
|
58 |
58 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
48 |
38 |
$2K |
| 0071A |
|
55 |
55 |
$2K |
| 85018 |
|
980 |
945 |
$2K |
| 0003A |
|
40 |
40 |
$2K |
| 0002A |
|
34 |
34 |
$1K |
| 90686 |
|
158 |
158 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
159 |
151 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
12 |
12 |
$763.43 |
| 0001A |
|
16 |
16 |
$640.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$619.08 |
| 90658 |
|
111 |
108 |
$568.68 |
| 81002 |
|
230 |
229 |
$349.72 |
| 92081 |
|
72 |
72 |
$0.00 |