| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,013 |
801 |
$50K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
98 |
95 |
$7K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
477 |
466 |
$7K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
70 |
70 |
$6K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
40 |
40 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
19 |
19 |
$2K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
169 |
163 |
$1K |
| 90686 |
|
13 |
13 |
$227.63 |
| 81000 |
|
119 |
119 |
$164.22 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
12 |
12 |
$57.00 |