| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,714 |
2,675 |
$176K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,379 |
2,337 |
$158K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,651 |
2,581 |
$124K |
| 90461 |
|
1,586 |
1,538 |
$109K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
298 |
287 |
$24K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
688 |
653 |
$23K |
| 0012A |
|
227 |
226 |
$7K |
| 0011A |
|
245 |
243 |
$7K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
77 |
77 |
$6K |
| 83655 |
|
355 |
354 |
$6K |
| 99381 |
|
74 |
67 |
$6K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
270 |
262 |
$6K |
| 90632 |
|
86 |
85 |
$5K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
62 |
62 |
$4K |
| 0064A |
|
99 |
97 |
$3K |
| 90671 |
|
253 |
244 |
$2K |
| 99382 |
|
28 |
26 |
$2K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
28 |
28 |
$1K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
28 |
28 |
$1K |
| 90651 |
|
211 |
210 |
$1K |
| 0031A |
|
48 |
48 |
$1K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
74 |
65 |
$1K |
| S4993 |
Contraceptive pills for birth control |
53 |
52 |
$1K |
| 90686 |
|
200 |
198 |
$1K |
| 90633 |
|
763 |
753 |
$1K |
| 90734 |
|
196 |
194 |
$978.90 |
| 90688 |
|
85 |
85 |
$880.70 |
| 90670 |
|
529 |
526 |
$736.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
13 |
13 |
$735.76 |
| 86580 |
|
81 |
71 |
$526.68 |
| 0001A |
|
12 |
12 |
$440.00 |
| 90697 |
|
85 |
83 |
$398.31 |
| 90647 |
|
321 |
319 |
$349.60 |
| 36416 |
|
137 |
135 |
$255.00 |
| 90680 |
|
153 |
151 |
$184.00 |
| 90710 |
|
67 |
64 |
$165.60 |
| 90723 |
|
108 |
107 |
$147.20 |
| 85018 |
|
31 |
31 |
$79.30 |
| 90716 |
|
30 |
30 |
$55.20 |
| 90696 |
|
15 |
15 |
$55.20 |
| 90715 |
|
49 |
49 |
$36.80 |
| 90685 |
|
30 |
29 |
$36.80 |
| 90698 |
|
12 |
12 |
$18.40 |
| 91303 |
|
13 |
13 |
$0.00 |
| 91301 |
|
114 |
98 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
21 |
19 |
$0.00 |