| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
273 |
138 |
$4K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
126 |
97 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
120 |
79 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
31 |
25 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
19 |
13 |
$940.92 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
14 |
13 |
$927.53 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
14 |
13 |
$853.29 |
| 92551 |
|
131 |
116 |
$845.03 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
55 |
35 |
$493.02 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
116 |
73 |
$483.40 |
| 99173 |
|
179 |
119 |
$202.40 |
| 96127 |
|
146 |
84 |
$187.50 |
| 81003 |
|
189 |
123 |
$153.94 |
| 85018 |
|
17 |
12 |
$26.46 |
| T1015 |
Clinic visit/encounter, all-inclusive |
352 |
56 |
$0.00 |