| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
12,097 |
11,254 |
$1.15M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,431 |
2,276 |
$321K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,448 |
1,320 |
$88K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,428 |
1,298 |
$83K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,119 |
1,057 |
$71K |
| 90686 |
|
3,469 |
3,351 |
$31K |
| 99173 |
|
7,192 |
6,332 |
$30K |
| 92551 |
|
6,380 |
5,673 |
$28K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
398 |
361 |
$24K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
580 |
555 |
$12K |
| 96127 |
|
1,787 |
1,679 |
$7K |
| 90756 |
|
983 |
859 |
$6K |
| 90648 |
|
905 |
818 |
$6K |
| 90670 |
|
808 |
726 |
$6K |
| 90791 |
Psychiatric diagnostic evaluation |
46 |
28 |
$5K |
| 0071A |
|
75 |
75 |
$3K |
| 0001A |
|
175 |
173 |
$3K |
| 90723 |
|
350 |
323 |
$2K |
| 0002A |
|
101 |
91 |
$2K |
| 96161 |
|
284 |
278 |
$2K |
| 0072A |
|
34 |
34 |
$1K |
| 90680 |
|
186 |
162 |
$1K |
| 90633 |
|
147 |
134 |
$1K |
| 90649 |
|
152 |
121 |
$944.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
49 |
49 |
$926.59 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
25 |
25 |
$687.03 |
| 90716 |
|
82 |
78 |
$544.00 |
| 90707 |
|
81 |
77 |
$536.00 |
| 90656 |
|
15 |
15 |
$335.25 |
| 94760 |
|
135 |
74 |
$203.02 |
| 90734 |
|
42 |
25 |
$168.00 |
| 90671 |
|
18 |
18 |
$128.00 |
| 90677 |
|
12 |
12 |
$96.00 |
| 90651 |
|
12 |
12 |
$88.00 |
| 88189 |
|
15 |
15 |
$0.00 |
| 99472 |
Subsequent inpatient pediatric critical care, per day, 2-5 years |
32 |
15 |
$0.00 |
| 17110 |
|
15 |
13 |
$0.00 |