| Code | Description | Claims | Beneficiaries | Total Paid |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
4,679 |
2,401 |
$17K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
918 |
912 |
$14K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
507 |
492 |
$11K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
370 |
365 |
$6K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
144 |
142 |
$3K |
| 92552 |
|
612 |
611 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
7,773 |
7,234 |
$2K |
| 90670 |
|
277 |
270 |
$2K |
| 90716 |
|
164 |
161 |
$1K |
| 90698 |
|
196 |
193 |
$769.72 |
| 99460 |
|
187 |
186 |
$713.72 |
| 99173 |
|
545 |
544 |
$442.80 |
| 90707 |
|
130 |
128 |
$378.32 |
| 99462 |
|
118 |
118 |
$326.64 |
| 90633 |
|
106 |
106 |
$295.66 |
| 90744 |
|
95 |
95 |
$247.05 |
| 90700 |
|
94 |
93 |
$214.18 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
156 |
154 |
$210.18 |
| 99215 |
Prolong outpt/office vis |
219 |
213 |
$205.04 |
| 90680 |
|
25 |
24 |
$108.00 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
384 |
377 |
$93.23 |
| 90713 |
|
25 |
24 |
$36.87 |
| 92081 |
|
44 |
44 |
$32.62 |
| 92551 |
|
111 |
111 |
$32.03 |
| 90686 |
|
54 |
53 |
$9.00 |
| 90461 |
|
165 |
164 |
$0.00 |
| 90734 |
|
27 |
26 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
105 |
105 |
$0.00 |
| 90648 |
|
12 |
12 |
$0.00 |
| 90677 |
|
29 |
29 |
$0.00 |