| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,426 |
1,419 |
$106K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
629 |
587 |
$33K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
802 |
761 |
$23K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
344 |
343 |
$17K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
65 |
65 |
$5K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
936 |
924 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
54 |
51 |
$4K |
| 90670 |
|
557 |
557 |
$2K |
| 83655 |
|
12 |
12 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
169 |
117 |
$1K |
| 90686 |
|
628 |
628 |
$950.58 |
| 90648 |
|
548 |
548 |
$890.24 |
| 90474 |
|
411 |
411 |
$368.78 |
| 90633 |
|
84 |
84 |
$0.00 |
| 90680 |
|
398 |
398 |
$0.00 |
| 90723 |
|
443 |
443 |
$0.00 |