| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,917 |
1,839 |
$33K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
327 |
321 |
$11K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
162 |
161 |
$5K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
94 |
94 |
$3K |
| 90461 |
|
146 |
142 |
$2K |
| 90686 |
|
334 |
329 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,635 |
2,405 |
$2K |
| 92551 |
|
1,412 |
1,407 |
$722.40 |
| 90688 |
|
26 |
26 |
$410.02 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
12 |
12 |
$363.00 |
| 90656 |
|
57 |
56 |
$98.08 |
| 96127 |
|
46 |
45 |
$6.04 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
42 |
40 |
$0.00 |
| 99173 |
|
333 |
333 |
$0.00 |
| 99072 |
|
54 |
50 |
$0.00 |