| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
3,276 |
3,069 |
$119K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
4,078 |
3,866 |
$115K |
| 99381 |
|
753 |
741 |
$76K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,968 |
4,539 |
$69K |
| 99460 |
|
1,064 |
1,060 |
$51K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,356 |
1,309 |
$34K |
| 90670 |
|
3,365 |
3,292 |
$21K |
| 90698 |
|
3,369 |
3,302 |
$20K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,074 |
1,092 |
$17K |
| 99462 |
|
742 |
604 |
$13K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
423 |
397 |
$11K |
| 90685 |
|
905 |
807 |
$9K |
| 90686 |
|
1,272 |
1,271 |
$9K |
| 90681 |
|
1,541 |
1,506 |
$9K |
| 90744 |
|
1,534 |
1,489 |
$8K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
4,641 |
4,595 |
$8K |
| 90633 |
|
1,582 |
1,534 |
$8K |
| 92552 |
|
715 |
715 |
$5K |
| 90688 |
|
803 |
766 |
$4K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
435 |
428 |
$3K |
| 90710 |
|
418 |
406 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
508 |
508 |
$2K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
258 |
257 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
89 |
88 |
$2K |
| 90707 |
|
347 |
340 |
$1K |
| 90716 |
|
333 |
329 |
$1K |
| 90651 |
|
136 |
136 |
$1K |
| 90696 |
|
221 |
214 |
$963.00 |
| 92551 |
|
85 |
85 |
$933.00 |
| 0071A |
|
30 |
16 |
$640.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
113 |
113 |
$608.00 |
| 90461 |
|
156 |
132 |
$316.20 |
| 90734 |
|
60 |
59 |
$217.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
12 |
12 |
$184.00 |
| 96160 |
|
4,606 |
4,600 |
$177.00 |
| 90700 |
|
32 |
29 |
$153.00 |
| 90648 |
|
20 |
17 |
$90.00 |
| 90620 |
|
39 |
38 |
$69.00 |
| 99173 |
|
21 |
21 |
$68.04 |
| 96127 |
|
25 |
25 |
$59.52 |
| 0072A |
|
13 |
13 |
$0.00 |
| 92081 |
|
69 |
69 |
$0.00 |