| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
294 |
284 |
$6K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
67 |
65 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
66 |
65 |
$2K |
| 90461 |
|
106 |
104 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
68 |
60 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
225 |
218 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
163 |
159 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
34 |
34 |
$999.50 |
| 90686 |
|
159 |
154 |
$352.96 |
| 90619 |
|
17 |
16 |
$155.00 |
| 90633 |
|
12 |
12 |
$37.74 |
| 85018 |
|
14 |
14 |
$18.28 |
| 3008F |
|
644 |
609 |
$0.00 |
| 2001F |
|
689 |
647 |
$0.00 |
| 3074F |
|
404 |
390 |
$0.00 |
| 4037F |
|
190 |
186 |
$0.00 |
| 2010F |
|
696 |
652 |
$0.00 |
| 90651 |
|
21 |
20 |
$0.00 |
| 1126F |
|
134 |
132 |
$0.00 |
| 3351F |
|
16 |
16 |
$0.00 |
| 2000F |
|
459 |
443 |
$0.00 |
| 90677 |
|
14 |
14 |
$0.00 |
| 4040F |
|
190 |
174 |
$0.00 |
| 3078F |
|
392 |
378 |
$0.00 |
| 4274F |
|
508 |
472 |
$0.00 |
| 1159F |
|
275 |
261 |
$0.00 |
| 1160F |
|
275 |
261 |
$0.00 |