| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
696 |
665 |
$21K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
273 |
267 |
$18K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
163 |
161 |
$11K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
81 |
80 |
$5K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
34 |
33 |
$3K |
| 92552 |
|
752 |
733 |
$2K |
| 99173 |
|
785 |
763 |
$2K |
| 85018 |
|
462 |
453 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
13 |
12 |
$772.18 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
33 |
24 |
$626.60 |
| 90734 |
|
47 |
40 |
$220.00 |
| 90670 |
|
15 |
15 |
$150.00 |
| 90633 |
|
12 |
12 |
$120.00 |
| 90698 |
|
12 |
12 |
$118.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
800 |
780 |
$70.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
452 |
438 |
$50.00 |
| 90715 |
|
25 |
25 |
$50.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
16 |
14 |
$28.66 |
| 90651 |
|
50 |
50 |
$0.00 |
| 90686 |
|
12 |
12 |
$0.00 |