| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
29 |
29 |
$435.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
25 |
25 |
$375.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
28 |
28 |
$258.34 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
13 |
13 |
$147.90 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
16 |
16 |
$80.61 |
| 99000 |
|
20 |
20 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
18 |
18 |
$0.00 |
| 36425 |
|
16 |
16 |
$0.00 |