| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
135 |
135 |
$5K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
86 |
86 |
$4K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
44 |
44 |
$2K |
| 92551 |
|
76 |
76 |
$767.60 |
| 85018 |
|
194 |
194 |
$395.65 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
201 |
201 |
$30.94 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
15 |
15 |
$23.76 |
| 90686 |
|
21 |
21 |
$0.00 |
| 90688 |
|
14 |
14 |
$0.00 |
| 90670 |
|
45 |
45 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
115 |
115 |
$0.00 |
| 90633 |
|
14 |
14 |
$0.00 |