| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,451 |
2,376 |
$103K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
867 |
653 |
$39K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
391 |
299 |
$4K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
44 |
36 |
$3K |
| 93000 |
|
347 |
252 |
$3K |
| 92551 |
|
317 |
253 |
$2K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
111 |
74 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
172 |
116 |
$2K |
| 99401 |
|
201 |
140 |
$2K |
| 85018 |
|
504 |
394 |
$971.40 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
15 |
13 |
$947.32 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
19 |
14 |
$941.40 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
15 |
12 |
$711.09 |
| 90674 |
|
42 |
37 |
$670.21 |
| 99173 |
|
337 |
267 |
$471.16 |
| 71046 |
Radiologic examination, chest; 2 views |
41 |
30 |
$449.20 |
| 81003 |
|
99 |
77 |
$183.18 |
| 82948 |
|
77 |
65 |
$144.90 |
| 90686 |
|
103 |
71 |
$50.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
199 |
137 |
$0.00 |
| 3077F |
|
66 |
57 |
$0.00 |
| 3725F |
|
249 |
207 |
$0.00 |
| 3078F |
|
59 |
45 |
$0.00 |