| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
187 |
171 |
$12K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
412 |
409 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
13 |
12 |
$1K |
| 90686 |
|
140 |
138 |
$392.35 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
56 |
56 |
$58.08 |
| 99173 |
|
25 |
25 |
$0.00 |
| 90461 |
|
12 |
12 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
15 |
15 |
$0.00 |