| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
4,732 |
3,679 |
$28K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
575 |
575 |
$16K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
14,878 |
13,052 |
$14K |
| 92551 |
|
2,718 |
2,692 |
$13K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
378 |
378 |
$12K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
615 |
609 |
$10K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
715 |
699 |
$9K |
| 99173 |
|
2,743 |
2,712 |
$4K |
| G9920 |
Screening performed and negative |
1,220 |
1,182 |
$3K |
| 81000 |
|
2,878 |
2,822 |
$3K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
469 |
467 |
$3K |
| 83655 |
|
864 |
848 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,119 |
1,094 |
$3K |
| 85018 |
|
916 |
913 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
133 |
128 |
$2K |
| 90671 |
|
65 |
60 |
$878.70 |
| 99383 |
|
16 |
16 |
$570.12 |
| 90715 |
|
25 |
25 |
$496.50 |
| 90697 |
|
101 |
97 |
$435.11 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
251 |
249 |
$434.71 |
| 97802 |
|
255 |
247 |
$276.07 |
| 90461 |
|
874 |
823 |
$274.02 |
| 99382 |
|
13 |
13 |
$254.26 |
| 90651 |
|
107 |
105 |
$238.82 |
| 97803 |
|
618 |
613 |
$199.05 |
| 90633 |
|
355 |
344 |
$189.00 |
| 99490 |
Ccm add 20min |
167 |
167 |
$125.86 |
| 90688 |
|
136 |
131 |
$108.00 |
| 90716 |
|
145 |
136 |
$99.00 |
| 93000 |
|
36 |
36 |
$96.06 |
| 90686 |
|
176 |
173 |
$72.00 |
| 90670 |
|
142 |
138 |
$72.00 |
| 87430 |
|
675 |
648 |
$45.29 |
| 90680 |
|
63 |
62 |
$45.00 |
| 90658 |
|
200 |
199 |
$45.00 |
| 90707 |
|
71 |
66 |
$45.00 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
1,142 |
1,124 |
$42.94 |
| 88738 |
|
1,954 |
1,932 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
156 |
154 |
$0.00 |
| 90677 |
|
86 |
86 |
$0.00 |
| 99441 |
|
87 |
79 |
$0.00 |
| 88150 |
|
13 |
13 |
$0.00 |
| 3008F |
|
29 |
29 |
$0.00 |
| 3074F |
|
28 |
27 |
$0.00 |
| 3078F |
|
26 |
25 |
$0.00 |
| 90734 |
|
12 |
12 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
12 |
12 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
30 |
28 |
$0.00 |
| 90710 |
|
14 |
14 |
$0.00 |