| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,798 |
1,613 |
$26K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
154 |
153 |
$5K |
| 92552 |
|
310 |
299 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
72 |
72 |
$3K |
| 97802 |
|
378 |
371 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
492 |
284 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
27 |
27 |
$2K |
| 90686 |
|
286 |
286 |
$2K |
| 90700 |
|
222 |
216 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
64 |
63 |
$1K |
| 90688 |
|
262 |
255 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
36 |
36 |
$1K |
| 96156 |
|
47 |
41 |
$1K |
| 90713 |
|
127 |
125 |
$873.00 |
| 90670 |
|
83 |
81 |
$856.59 |
| 90648 |
|
97 |
95 |
$757.53 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
12 |
12 |
$594.00 |
| 90685 |
|
33 |
26 |
$409.85 |
| G9920 |
Screening performed and negative |
43 |
43 |
$319.00 |
| 99173 |
|
119 |
117 |
$247.82 |
| 99406 |
|
14 |
14 |
$61.96 |
| 90744 |
|
12 |
12 |
$54.00 |
| 90716 |
|
13 |
13 |
$36.00 |
| 96127 |
|
14 |
14 |
$28.61 |
| 81002 |
|
17 |
14 |
$23.22 |
| 90461 |
|
18 |
13 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
287 |
279 |
$0.00 |