| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,046 |
849 |
$64K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,046 |
936 |
$47K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,108 |
1,008 |
$14K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
301 |
264 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
25 |
25 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
236 |
220 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
15 |
14 |
$1K |
| 90686 |
|
168 |
159 |
$846.38 |
| 92587 |
|
75 |
69 |
$497.44 |
| 99173 |
|
171 |
162 |
$371.60 |
| 96127 |
|
165 |
119 |
$352.04 |
| 90656 |
|
12 |
12 |
$247.19 |
| 99174 |
|
22 |
14 |
$48.06 |
| 99072 |
|
121 |
119 |
$0.00 |