| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
426 |
346 |
$19K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
86 |
79 |
$6K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
65 |
57 |
$4K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
69 |
58 |
$4K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
212 |
179 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
39 |
39 |
$3K |
| 92552 |
|
158 |
146 |
$3K |
| 97803 |
|
176 |
162 |
$2K |
| 92015 |
Determination of refractive state |
170 |
154 |
$2K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
107 |
93 |
$2K |
| 36416 |
|
198 |
178 |
$1K |
| 96127 |
|
341 |
263 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
140 |
123 |
$882.00 |
| 87430 |
|
56 |
52 |
$723.84 |
| 85018 |
|
165 |
164 |
$398.59 |
| 96161 |
|
66 |
55 |
$111.18 |
| 90670 |
|
61 |
53 |
$0.00 |
| 90700 |
|
26 |
24 |
$0.00 |
| 90647 |
|
53 |
46 |
$0.00 |
| 3008F |
|
79 |
67 |
$0.00 |
| 90680 |
|
30 |
26 |
$0.00 |
| 90651 |
|
15 |
14 |
$0.00 |
| 2000F |
|
45 |
39 |
$0.00 |