| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,571 |
1,999 |
$174K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,096 |
1,676 |
$40K |
| 99199 |
Unlisted special service, procedure or report |
12,969 |
12,612 |
$36K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
321 |
263 |
$31K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
293 |
211 |
$29K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
296 |
267 |
$27K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
812 |
636 |
$25K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
200 |
149 |
$18K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
152 |
117 |
$16K |
| 96127 |
|
2,431 |
1,937 |
$13K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,296 |
1,036 |
$12K |
| 99442 |
|
32 |
25 |
$1K |
| 90686 |
|
689 |
571 |
$426.52 |
| 90474 |
|
12 |
12 |
$245.40 |
| 90680 |
|
12 |
12 |
$0.00 |
| 90723 |
|
12 |
12 |
$0.00 |
| 90647 |
|
18 |
12 |
$0.00 |
| 90670 |
|
71 |
52 |
$0.00 |
| 90685 |
|
27 |
26 |
$0.00 |