| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,422 |
3,019 |
$105K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,236 |
1,089 |
$46K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
277 |
275 |
$23K |
| 99000 |
|
1,948 |
1,753 |
$17K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,382 |
654 |
$13K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
610 |
570 |
$13K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
83 |
83 |
$6K |
| 90658 |
|
203 |
200 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
24 |
24 |
$2K |
| 97169 |
|
118 |
116 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
24 |
24 |
$2K |
| 97802 |
|
1,560 |
1,521 |
$2K |
| 0001A |
|
79 |
78 |
$1K |
| 99385 |
|
16 |
15 |
$1K |
| 92551 |
|
325 |
317 |
$993.67 |
| 0002A |
|
71 |
71 |
$975.00 |
| 81002 |
|
768 |
711 |
$972.81 |
| 90461 |
|
157 |
125 |
$941.00 |
| 96160 |
|
522 |
508 |
$857.02 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
93 |
80 |
$830.77 |
| 90734 |
|
54 |
52 |
$750.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
27 |
25 |
$194.83 |
| 81025 |
|
12 |
12 |
$43.38 |
| 82962 |
|
48 |
39 |
$0.00 |
| 99173 |
|
1,158 |
1,128 |
$0.00 |
| 91300 |
|
173 |
157 |
$0.00 |