| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
842 |
800 |
$58K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
829 |
655 |
$23K |
| 99173 |
|
233 |
206 |
$5K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
48 |
42 |
$4K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
512 |
428 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
24 |
24 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
84 |
84 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
12 |
12 |
$1K |
| 96127 |
|
68 |
68 |
$704.88 |
| 90461 |
|
16 |
14 |
$611.35 |
| 99442 |
|
12 |
12 |
$255.19 |
| 99441 |
|
14 |
13 |
$155.45 |
| 90658 |
|
171 |
170 |
$0.01 |
| 90657 |
|
41 |
40 |
$0.00 |
| 90686 |
|
145 |
145 |
$0.00 |
| 99000 |
|
12 |
12 |
$0.00 |