| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,025 |
2,810 |
$215K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
837 |
796 |
$83K |
| 96131 |
|
216 |
212 |
$20K |
| 96130 |
|
294 |
289 |
$19K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
87 |
87 |
$9K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
63 |
63 |
$6K |
| 96101 |
|
12 |
12 |
$3K |
| 90686 |
|
170 |
170 |
$3K |
| 90688 |
|
139 |
132 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
12 |
12 |
$1K |
| 96137 |
|
30 |
27 |
$1K |
| 90480 |
|
26 |
26 |
$960.00 |
| 99177 |
|
359 |
356 |
$932.84 |
| 0071A |
|
20 |
20 |
$800.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
41 |
41 |
$763.20 |
| 0072A |
|
19 |
19 |
$760.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
70 |
42 |
$752.08 |
| 96136 |
|
30 |
27 |
$744.69 |
| 90672 |
|
43 |
43 |
$673.43 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
36 |
28 |
$313.19 |