| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,154 |
2,926 |
$214K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,192 |
1,181 |
$115K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,018 |
1,001 |
$89K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
304 |
301 |
$26K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
195 |
193 |
$19K |
| 90686 |
|
936 |
911 |
$12K |
| 90670 |
|
458 |
453 |
$6K |
| 90680 |
|
186 |
184 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
110 |
110 |
$2K |
| 92551 |
|
273 |
270 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
17 |
17 |
$2K |
| 90698 |
|
139 |
137 |
$2K |
| 90697 |
|
69 |
69 |
$1K |
| 0071A |
|
18 |
18 |
$720.00 |
| 90685 |
|
41 |
41 |
$650.80 |
| 0072A |
|
15 |
15 |
$600.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
24 |
24 |
$494.67 |
| 90688 |
|
33 |
33 |
$411.75 |
| 90672 |
|
27 |
27 |
$400.31 |
| 99173 |
|
220 |
219 |
$379.29 |
| 90744 |
|
25 |
25 |
$318.96 |
| 90677 |
|
12 |
12 |
$216.59 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
13 |
12 |
$182.87 |
| 99177 |
|
38 |
38 |
$181.46 |
| 90633 |
|
13 |
12 |
$178.97 |
| 90656 |
|
44 |
44 |
$135.01 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
13 |
13 |
$76.18 |
| 36416 |
|
25 |
25 |
$59.29 |