| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
5,225 |
5,218 |
$148K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
3,790 |
3,787 |
$82K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
19,519 |
11,960 |
$75K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,826 |
1,824 |
$52K |
| 90480 |
|
766 |
763 |
$43K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,010 |
2,007 |
$41K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
794 |
790 |
$35K |
| 0004A |
|
484 |
484 |
$26K |
| 99188 |
|
2,110 |
2,107 |
$20K |
| 90461 |
|
3,223 |
2,776 |
$13K |
| 0073A |
|
290 |
289 |
$7K |
| 0074A |
|
68 |
68 |
$4K |
| 90686 |
|
1,052 |
1,048 |
$3K |
| 91322 |
|
12 |
12 |
$3K |
| 0003A |
|
666 |
663 |
$3K |
| 0083A |
|
39 |
39 |
$2K |
| 90672 |
|
185 |
185 |
$1K |
| 0082A |
|
57 |
57 |
$840.00 |
| 86580 |
|
1,333 |
1,332 |
$453.60 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
70 |
70 |
$445.50 |
| 81002 |
|
93 |
93 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
3,546 |
3,443 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
12 |
12 |
$0.00 |
| 90670 |
|
55 |
55 |
$0.00 |
| 90715 |
|
110 |
108 |
$0.00 |
| 90649 |
|
115 |
114 |
$0.00 |
| 90734 |
|
96 |
95 |
$0.00 |
| 90685 |
|
18 |
18 |
$0.00 |
| 90621 |
|
149 |
138 |
$0.00 |
| 0071A |
|
359 |
359 |
$0.00 |
| 0002A |
|
79 |
76 |
$0.00 |
| 90633 |
|
46 |
43 |
$0.00 |
| 90707 |
|
26 |
26 |
$0.00 |
| 90648 |
|
13 |
13 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
11,426 |
10,352 |
$0.00 |
| 97802 |
|
6,751 |
6,744 |
$0.00 |
| 90660 |
|
40 |
40 |
$0.00 |
| 0072A |
|
367 |
366 |
$0.00 |
| 90744 |
|
53 |
53 |
$0.00 |
| 0001A |
|
72 |
72 |
$0.00 |
| 0081A |
|
55 |
55 |
$0.00 |
| 90716 |
|
30 |
30 |
$0.00 |