| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
113 |
104 |
$10K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
153 |
142 |
$9K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
83 |
78 |
$7K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
267 |
252 |
$3K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
148 |
98 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
27 |
27 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
15 |
13 |
$1K |
| 96127 |
|
125 |
115 |
$576.72 |
| 87430 |
|
14 |
14 |
$236.74 |
| 87081 |
|
17 |
17 |
$164.34 |
| 3008F |
|
13 |
13 |
$0.00 |
| 1160F |
|
13 |
12 |
$0.00 |
| 4004F |
|
14 |
13 |
$0.00 |