| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
587 |
573 |
$24K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
219 |
219 |
$17K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
876 |
875 |
$10K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
117 |
117 |
$9K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
89 |
87 |
$7K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
86 |
84 |
$6K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
501 |
496 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
26 |
26 |
$2K |
| 90688 |
|
211 |
211 |
$2K |
| 90698 |
|
94 |
94 |
$962.55 |
| 90670 |
|
96 |
96 |
$699.20 |
| 99460 |
|
12 |
12 |
$551.88 |
| 90744 |
|
27 |
27 |
$498.33 |
| 94010 |
|
13 |
13 |
$464.62 |
| 90680 |
|
25 |
25 |
$460.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
19 |
15 |
$181.12 |
| 96161 |
|
41 |
39 |
$170.97 |
| 90686 |
|
43 |
43 |
$38.06 |
| 90474 |
|
25 |
25 |
$18.40 |
| 90687 |
|
30 |
30 |
$9.40 |
| 3008F |
|
551 |
551 |
$0.00 |
| 2014F |
|
93 |
93 |
$0.00 |