| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
447 |
405 |
$28K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
476 |
447 |
$20K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
456 |
365 |
$7K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
67 |
66 |
$6K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
72 |
65 |
$6K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
28 |
25 |
$2K |
| 99173 |
|
381 |
356 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
160 |
113 |
$2K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
121 |
118 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
13 |
12 |
$1K |
| 90686 |
|
190 |
184 |
$38.45 |
| 90672 |
|
12 |
12 |
$0.00 |
| 90670 |
|
28 |
27 |
$0.00 |
| 90688 |
|
120 |
89 |
$0.00 |
| 91307 |
|
31 |
29 |
$0.00 |
| 90698 |
|
25 |
25 |
$0.00 |