| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
128 |
127 |
$5K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
44 |
44 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
36 |
36 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
27 |
27 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
12 |
12 |
$132.00 |
| 96127 |
|
38 |
30 |
$86.30 |
| 92551 |
|
97 |
97 |
$62.44 |
| 96160 |
|
36 |
36 |
$61.30 |
| 99173 |
|
91 |
91 |
$24.00 |
| 90734 |
|
15 |
15 |
$0.00 |
| 90710 |
|
15 |
15 |
$0.00 |
| 90715 |
|
12 |
12 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
27 |
27 |
$0.00 |
| 90651 |
|
14 |
14 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
12 |
12 |
$0.00 |