| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,043 |
996 |
$54K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
408 |
395 |
$29K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
308 |
306 |
$12K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
317 |
303 |
$10K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,436 |
1,394 |
$7K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
282 |
282 |
$7K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
630 |
613 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
27 |
26 |
$602.59 |
| 87428 |
|
12 |
12 |
$508.72 |
| 90686 |
|
421 |
406 |
$111.62 |
| 90656 |
|
73 |
72 |
$53.53 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
21 |
14 |
$47.22 |
| 90473 |
|
15 |
15 |
$20.72 |
| 90480 |
|
26 |
26 |
$14.10 |
| 90677 |
|
91 |
89 |
$0.00 |
| 90680 |
|
40 |
39 |
$0.00 |
| 90696 |
|
12 |
12 |
$0.00 |
| 90723 |
|
70 |
69 |
$0.00 |
| 99177 |
|
59 |
59 |
$0.00 |
| 96381 |
|
12 |
12 |
$0.00 |
| 90710 |
|
12 |
12 |
$0.00 |
| 90648 |
|
163 |
159 |
$0.00 |
| 90670 |
|
49 |
47 |
$0.00 |