| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,939 |
5,399 |
$47K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
197 |
177 |
$16K |
| 92551 |
|
859 |
850 |
$8K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
733 |
732 |
$7K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
619 |
615 |
$6K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
55 |
55 |
$6K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
493 |
493 |
$6K |
| 90686 |
|
1,020 |
1,015 |
$4K |
| 90648 |
|
360 |
359 |
$2K |
| 90670 |
|
376 |
375 |
$2K |
| 97803 |
|
678 |
678 |
$2K |
| 99381 |
|
13 |
13 |
$2K |
| 90680 |
|
161 |
161 |
$2K |
| 90723 |
|
167 |
167 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
68 |
31 |
$549.44 |
| 90651 |
|
175 |
175 |
$306.00 |
| 92552 |
|
27 |
27 |
$270.66 |
| 90734 |
|
63 |
63 |
$135.00 |
| 90655 |
|
13 |
13 |
$117.00 |
| 99173 |
|
27 |
27 |
$77.20 |
| S9451 |
Exercise classes, non-physician provider, per session |
136 |
136 |
$36.00 |
| 90715 |
|
20 |
20 |
$18.00 |
| 90633 |
|
12 |
12 |
$0.00 |
| 90461 |
|
13 |
12 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
592 |
592 |
$0.00 |
| 90688 |
|
13 |
13 |
$0.00 |
| 92060 |
|
13 |
13 |
$0.00 |