| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
357 |
355 |
$15K |
| 90461 |
|
91 |
90 |
$4K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
73 |
72 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
43 |
42 |
$3K |
| 92551 |
|
67 |
67 |
$464.78 |
| 99173 |
|
74 |
74 |
$0.00 |
| 90670 |
|
24 |
24 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
24 |
24 |
$0.00 |
| 3008F |
|
156 |
155 |
$0.00 |
| 1126F |
|
175 |
170 |
$0.00 |
| 90686 |
|
70 |
70 |
$0.00 |
| 96127 |
|
22 |
22 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
13 |
13 |
$0.00 |