| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
223 |
223 |
$2K |
| 92552 |
|
725 |
724 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
849 |
792 |
$906.85 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
481 |
475 |
$547.49 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
161 |
161 |
$380.62 |
| 99173 |
|
708 |
706 |
$296.26 |
| 83026 |
|
558 |
557 |
$290.58 |
| 81003 |
|
452 |
451 |
$239.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
149 |
126 |
$226.80 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
338 |
329 |
$181.96 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
179 |
178 |
$162.41 |
| 97802 |
|
274 |
274 |
$0.00 |
| 90686 |
|
51 |
51 |
$0.00 |
| 90620 |
|
14 |
14 |
$0.00 |
| 90734 |
|
28 |
28 |
$0.00 |
| 90658 |
|
36 |
36 |
$0.00 |