| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,003 |
722 |
$42K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
523 |
413 |
$12K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
182 |
172 |
$9K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
97 |
93 |
$7K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
162 |
138 |
$4K |
| 83655 |
|
28 |
25 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
61 |
60 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
115 |
112 |
$2K |
| 90686 |
|
482 |
293 |
$740.96 |
| 90648 |
|
67 |
67 |
$131.50 |
| 90670 |
|
56 |
54 |
$0.00 |
| 90633 |
|
12 |
12 |
$0.00 |
| 90685 |
|
13 |
13 |
$0.00 |