| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
263 |
254 |
$27K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
113 |
113 |
$11K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
499 |
497 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
27 |
26 |
$1K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
394 |
394 |
$1K |
| 99072 |
|
91 |
87 |
$387.10 |
| 90686 |
|
143 |
143 |
$361.52 |
| 90473 |
|
24 |
24 |
$302.08 |
| 90685 |
|
81 |
81 |
$241.43 |
| 90744 |
|
12 |
12 |
$126.76 |
| 90698 |
|
79 |
79 |
$43.56 |
| 90680 |
|
27 |
27 |
$0.00 |
| 90670 |
|
173 |
173 |
$0.00 |