| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 96156 |
|
250 |
235 |
$26K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
219 |
199 |
$10K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
258 |
215 |
$8K |
| 90670 |
|
131 |
120 |
$1K |
| 90723 |
|
75 |
70 |
$603.00 |
| 90686 |
|
52 |
52 |
$441.00 |
| 90647 |
|
34 |
27 |
$288.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
12 |
12 |
$69.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
237 |
188 |
$0.00 |
| 99072 |
|
650 |
515 |
$0.00 |
| 90461 |
|
144 |
133 |
$0.00 |