| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
196 |
182 |
$19K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
137 |
135 |
$9K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
44 |
44 |
$5K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
343 |
343 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
15 |
15 |
$1K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
287 |
287 |
$633.42 |
| 99072 |
|
112 |
105 |
$97.56 |
| 90685 |
|
13 |
13 |
$20.72 |
| 90686 |
|
70 |
70 |
$0.00 |
| 90744 |
|
12 |
12 |
$0.00 |
| 90698 |
|
12 |
12 |
$0.00 |
| 90670 |
|
50 |
50 |
$0.00 |