| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,089 |
1,876 |
$83K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
744 |
732 |
$35K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
235 |
232 |
$7K |
| 96127 |
|
1,623 |
1,584 |
$5K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
81 |
77 |
$5K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
29 |
29 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
27 |
26 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
13 |
13 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
26 |
26 |
$526.76 |
| 94760 |
|
74 |
63 |
$48.33 |
| 99072 |
|
2,321 |
2,067 |
$33.75 |
| 85014 |
|
12 |
12 |
$24.12 |
| 99000 |
|
65 |
60 |
$0.00 |
| 90656 |
|
48 |
48 |
$0.00 |
| 90686 |
|
317 |
309 |
$0.00 |
| 36416 |
|
12 |
12 |
$0.00 |
| 91307 |
|
18 |
12 |
$0.00 |
| G9920 |
Screening performed and negative |
277 |
273 |
$0.00 |
| 99177 |
|
115 |
114 |
$0.00 |
| 90670 |
|
15 |
15 |
$0.00 |