| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,155 |
625 |
$12K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
124 |
124 |
$5K |
| 92552 |
|
635 |
633 |
$5K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
118 |
118 |
$5K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
90 |
90 |
$4K |
| 90686 |
|
516 |
504 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,504 |
1,386 |
$2K |
| 99173 |
|
352 |
352 |
$932.24 |
| 97803 |
|
409 |
408 |
$340.00 |
| 90651 |
|
107 |
107 |
$315.00 |
| 92060 |
|
201 |
201 |
$147.55 |
| S9451 |
Exercise classes, non-physician provider, per session |
439 |
438 |
$108.00 |
| 90734 |
|
43 |
43 |
$72.00 |
| 90670 |
|
14 |
14 |
$36.00 |