| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
258 |
257 |
$18K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
333 |
313 |
$13K |
| 90723 |
|
197 |
194 |
$5K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
57 |
57 |
$4K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
48 |
48 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
53 |
52 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
233 |
222 |
$3K |
| 90670 |
|
310 |
289 |
$2K |
| 90686 |
|
273 |
271 |
$2K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
126 |
118 |
$1K |
| 99188 |
|
62 |
60 |
$946.36 |
| 90647 |
|
165 |
155 |
$868.09 |
| 90681 |
|
44 |
39 |
$210.43 |
| 90633 |
|
25 |
25 |
$147.74 |