| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90472 |
Immunization administration, each additional vaccine (list separately) |
94 |
94 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
138 |
138 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
39 |
39 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
13 |
13 |
$409.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
12 |
12 |
$376.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
442 |
393 |
$136.44 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
47 |
47 |
$33.43 |
| 92567 |
|
13 |
13 |
$0.00 |