| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
87 |
87 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
45 |
45 |
$2K |
| 90700 |
|
70 |
70 |
$630.00 |
| 90655 |
|
61 |
61 |
$570.20 |
| 90647 |
|
61 |
61 |
$549.00 |
| 90670 |
|
57 |
57 |
$513.00 |
| 90713 |
|
47 |
47 |
$423.00 |
| 90633 |
|
38 |
38 |
$342.00 |
| 90716 |
|
26 |
26 |
$234.00 |
| 90658 |
|
18 |
18 |
$162.00 |
| 90707 |
|
13 |
13 |
$117.00 |
| 90681 |
|
12 |
12 |
$108.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
53 |
52 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
57 |
55 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
201 |
194 |
$0.00 |
| 3008F |
|
79 |
79 |
$0.00 |