| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90472 |
Immunization administration, each additional vaccine (list separately) |
3,128 |
2,322 |
$52K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
4,355 |
3,432 |
$39K |
| 90651 |
|
545 |
380 |
$6K |
| 90670 |
|
620 |
475 |
$3K |
| 90707 |
|
359 |
269 |
$2K |
| 90716 |
|
501 |
347 |
$2K |
| 90733 |
|
188 |
124 |
$1K |
| 90658 |
|
523 |
425 |
$1K |
| 96160 |
|
133 |
95 |
$1K |
| 90713 |
|
785 |
560 |
$1K |
| 90620 |
|
101 |
54 |
$964.50 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
24 |
18 |
$945.00 |
| 90700 |
|
1,274 |
980 |
$903.98 |
| 90633 |
|
405 |
335 |
$644.19 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
8,339 |
6,149 |
$429.61 |
| 90648 |
|
630 |
462 |
$429.00 |
| 99441 |
|
2,977 |
2,351 |
$410.22 |
| 90681 |
|
47 |
28 |
$383.82 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
9,580 |
6,647 |
$93.88 |
| 90744 |
|
118 |
79 |
$55.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,157 |
689 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
500 |
330 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
788 |
552 |
$0.00 |
| 99401 |
|
139 |
70 |
$0.00 |
| 83655 |
|
74 |
73 |
$0.00 |
| 99173 |
|
114 |
86 |
$0.00 |
| 90715 |
|
25 |
15 |
$0.00 |
| 99408 |
|
24 |
23 |
$0.00 |
| 80061 |
Lipid panel |
12 |
12 |
$0.00 |
| 90655 |
|
13 |
13 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
22 |
21 |
$0.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
21 |
21 |
$0.00 |
| 96127 |
|
45 |
43 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
88 |
74 |
$0.00 |