| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
852 |
720 |
$49K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
338 |
279 |
$13K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
473 |
347 |
$10K |
| 87428 |
|
145 |
124 |
$9K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
39 |
39 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
123 |
78 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
24 |
24 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
64 |
49 |
$830.69 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
17 |
17 |
$515.76 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
15 |
12 |
$180.78 |
| 96127 |
|
32 |
24 |
$159.42 |
| 87420 |
|
14 |
13 |
$143.82 |
| 99177 |
|
13 |
12 |
$67.39 |