| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
421 |
400 |
$21K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
149 |
149 |
$11K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
170 |
163 |
$7K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
98 |
94 |
$7K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
226 |
224 |
$4K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
36 |
36 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
19 |
19 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
40 |
40 |
$718.04 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
36 |
35 |
$434.70 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
64 |
64 |
$362.63 |
| 90474 |
|
30 |
30 |
$282.71 |
| 94760 |
|
117 |
111 |
$153.85 |
| 81002 |
|
77 |
77 |
$117.36 |
| 90651 |
|
13 |
13 |
$0.02 |
| 90680 |
|
33 |
33 |
$0.00 |
| 90686 |
|
14 |
14 |
$0.00 |
| 99000 |
|
27 |
27 |
$0.00 |
| 90698 |
|
12 |
12 |
$0.00 |
| 90633 |
|
76 |
75 |
$0.00 |
| 90670 |
|
74 |
74 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
13 |
13 |
$0.00 |
| 90648 |
|
12 |
12 |
$0.00 |
| 90734 |
|
13 |
13 |
$0.00 |