| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
31 |
28 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
37 |
37 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
325 |
325 |
$2K |
| 90686 |
|
100 |
100 |
$536.02 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
70 |
70 |
$236.01 |
| 90648 |
|
27 |
27 |
$0.00 |
| 99173 |
|
15 |
15 |
$0.00 |
| 90670 |
|
26 |
26 |
$0.00 |