| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
184 |
179 |
$2K |
| 90461 |
|
73 |
73 |
$816.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
57 |
57 |
$583.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
52 |
52 |
$577.30 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
29 |
29 |
$290.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
201 |
194 |
$204.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
14 |
14 |
$149.50 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
14 |
14 |
$140.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
96 |
96 |
$136.00 |
| 92552 |
|
92 |
92 |
$12.10 |
| 3008F |
|
97 |
97 |
$10.00 |
| 99173 |
|
88 |
88 |
$0.00 |