| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
4,194 |
2,695 |
$27K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
608 |
608 |
$20K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
687 |
673 |
$18K |
| 92552 |
|
1,750 |
1,749 |
$15K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
280 |
280 |
$12K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,624 |
2,479 |
$11K |
| 99173 |
|
1,777 |
1,777 |
$4K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
263 |
184 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
391 |
380 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
37 |
37 |
$862.88 |
| 90686 |
|
472 |
470 |
$766.38 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
460 |
438 |
$610.05 |
| 90670 |
|
150 |
149 |
$461.57 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
157 |
155 |
$218.64 |
| 90648 |
|
42 |
42 |
$144.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
427 |
422 |
$139.22 |
| 90461 |
|
804 |
679 |
$105.04 |
| 86580 |
|
25 |
25 |
$83.75 |
| 3074F |
|
419 |
403 |
$45.00 |
| 3078F |
|
417 |
401 |
$45.00 |
| 3008F |
|
811 |
760 |
$40.00 |
| 90657 |
|
12 |
12 |
$0.00 |
| 96156 |
|
13 |
13 |
$0.00 |
| 90651 |
|
74 |
74 |
$0.00 |
| 90620 |
|
13 |
13 |
$0.00 |
| 90716 |
|
12 |
12 |
$0.00 |
| 97802 |
|
13 |
13 |
$0.00 |
| 90658 |
|
37 |
37 |
$0.00 |
| 90672 |
|
16 |
15 |
$0.00 |
| G9920 |
Screening performed and negative |
13 |
13 |
$0.00 |
| 90700 |
|
16 |
16 |
$0.00 |
| 90707 |
|
12 |
12 |
$0.00 |
| 90633 |
|
13 |
13 |
$0.00 |