| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,959 |
1,036 |
$15K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
238 |
238 |
$8K |
| 92552 |
|
577 |
576 |
$6K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
136 |
136 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
93 |
93 |
$4K |
| 99173 |
|
537 |
537 |
$1K |
| 90656 |
|
220 |
219 |
$32.91 |
| 90651 |
|
44 |
44 |
$3.00 |
| 90670 |
|
15 |
15 |
$2.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
84 |
82 |
$0.00 |
| 90461 |
|
339 |
298 |
$0.00 |
| 90655 |
|
14 |
14 |
$0.00 |
| 90633 |
|
12 |
12 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
711 |
649 |
$0.00 |
| 90686 |
|
13 |
13 |
$0.00 |