| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,192 |
1,175 |
$55K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,332 |
1,307 |
$50K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,319 |
1,274 |
$45K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,000 |
4,479 |
$29K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
3,681 |
3,610 |
$18K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,575 |
1,552 |
$15K |
| 92552 |
|
1,545 |
1,544 |
$15K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
133 |
126 |
$13K |
| 99460 |
|
303 |
302 |
$13K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
288 |
261 |
$11K |
| 92551 |
|
1,023 |
1,013 |
$10K |
| 90686 |
|
1,646 |
1,607 |
$9K |
| 99462 |
|
329 |
263 |
$6K |
| 85018 |
|
2,211 |
2,195 |
$5K |
| 99173 |
|
1,438 |
1,438 |
$4K |
| 81000 |
|
1,449 |
1,436 |
$3K |
| 90700 |
|
515 |
513 |
$2K |
| 83026 |
|
898 |
898 |
$2K |
| 99222 |
Initial hospital care, per day, moderate complexity |
67 |
67 |
$2K |
| 86580 |
|
611 |
604 |
$2K |
| 81003 |
|
727 |
727 |
$2K |
| 90648 |
|
327 |
324 |
$2K |
| 90670 |
|
323 |
319 |
$2K |
| 90713 |
|
288 |
286 |
$1K |
| 90685 |
|
262 |
255 |
$1K |
| 83655 |
|
42 |
42 |
$955.80 |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
110 |
70 |
$761.50 |
| 99381 |
|
12 |
12 |
$478.98 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
12 |
12 |
$440.30 |
| 92081 |
|
414 |
414 |
$358.82 |
| 90744 |
|
37 |
37 |
$333.00 |
| 90651 |
|
98 |
98 |
$243.00 |
| 90707 |
|
55 |
55 |
$216.00 |
| 90680 |
|
39 |
39 |
$198.00 |
| 90716 |
|
52 |
52 |
$189.00 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
458 |
455 |
$110.34 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
43 |
40 |
$101.95 |
| 90734 |
|
36 |
36 |
$99.00 |
| 90633 |
|
12 |
12 |
$36.00 |
| 90715 |
|
13 |
13 |
$27.00 |
| 81002 |
|
335 |
335 |
$16.13 |
| 3074F |
|
166 |
166 |
$0.00 |
| 3078F |
|
163 |
163 |
$0.00 |