| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
200 |
178 |
$19K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
88 |
82 |
$9K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
89 |
86 |
$5K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
14 |
14 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
226 |
223 |
$989.73 |
| 90670 |
|
88 |
86 |
$506.67 |
| 90686 |
|
51 |
51 |
$445.61 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
199 |
197 |
$201.92 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
16 |
16 |
$0.00 |
| 90648 |
|
14 |
14 |
$0.00 |
| 90723 |
|
55 |
54 |
$0.00 |
| 90647 |
|
25 |
24 |
$0.00 |