| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
593 |
583 |
$15K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
125 |
119 |
$6K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
120 |
113 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$636.57 |
| 92552 |
|
12 |
12 |
$319.48 |
| 90670 |
|
12 |
12 |
$53.55 |
| 90698 |
|
13 |
13 |
$53.55 |
| 90656 |
|
35 |
35 |
$22.35 |
| 90685 |
|
17 |
16 |
$0.00 |
| 90686 |
|
47 |
46 |
$0.00 |