| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
765 |
733 |
$55K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
367 |
345 |
$38K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
111 |
111 |
$12K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
900 |
895 |
$6K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
29 |
29 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
28 |
28 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
16 |
15 |
$1K |
| 90686 |
|
220 |
220 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
548 |
466 |
$605.57 |
| 99177 |
|
287 |
287 |
$449.09 |
| 90473 |
|
25 |
25 |
$403.68 |
| 99051 |
|
104 |
103 |
$324.70 |
| 96161 |
|
128 |
119 |
$306.98 |
| 90672 |
|
31 |
31 |
$279.96 |
| 90685 |
|
34 |
34 |
$214.46 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
374 |
371 |
$172.93 |
| 90698 |
|
111 |
111 |
$147.24 |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
27 |
27 |
$0.00 |
| 36416 |
|
14 |
14 |
$0.00 |
| 90474 |
|
25 |
25 |
$0.00 |
| 90670 |
|
156 |
154 |
$0.00 |