| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
698 |
595 |
$47K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
342 |
290 |
$26K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
173 |
166 |
$13K |
| 90670 |
|
389 |
316 |
$11K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
162 |
152 |
$8K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
86 |
78 |
$6K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
37 |
30 |
$3K |
| 99381 |
|
29 |
29 |
$3K |
| 90680 |
|
165 |
140 |
$2K |
| 90698 |
|
125 |
109 |
$987.98 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
33 |
25 |
$835.05 |
| 90686 |
|
70 |
59 |
$468.43 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
696 |
582 |
$414.04 |
| 90744 |
|
34 |
30 |
$205.76 |
| 90648 |
|
18 |
15 |
$195.67 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
386 |
221 |
$158.96 |
| 90723 |
|
15 |
13 |
$157.99 |
| 90682 |
|
15 |
15 |
$44.80 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
55 |
47 |
$0.00 |
| 90461 |
|
47 |
41 |
$0.00 |