| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
4,153 |
3,749 |
$164K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
3,145 |
2,727 |
$129K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,853 |
3,124 |
$124K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
7,451 |
6,431 |
$74K |
| 90461 |
|
4,998 |
4,434 |
$47K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
703 |
673 |
$27K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
644 |
581 |
$25K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
683 |
639 |
$14K |
| 90670 |
|
773 |
754 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
263 |
109 |
$2K |
| 90716 |
|
397 |
338 |
$2K |
| 90633 |
|
774 |
684 |
$2K |
| 90723 |
|
1,044 |
1,023 |
$2K |
| 90707 |
|
368 |
312 |
$990.80 |
| 90647 |
|
887 |
806 |
$826.30 |
| G0008 |
Administration of influenza virus vaccine |
94 |
93 |
$650.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
213 |
159 |
$632.55 |
| 90658 |
|
41 |
41 |
$547.58 |
| 90700 |
|
296 |
295 |
$484.04 |
| 90686 |
|
1,342 |
894 |
$460.86 |
| G0009 |
Administration of pneumococcal vaccine |
53 |
53 |
$317.52 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
45 |
45 |
$276.98 |
| 90681 |
|
890 |
776 |
$229.63 |
| 96161 |
|
142 |
114 |
$224.37 |
| 90656 |
|
94 |
93 |
$72.66 |
| 96127 |
|
53 |
19 |
$51.34 |
| 90677 |
|
53 |
53 |
$0.20 |
| 90697 |
|
27 |
27 |
$0.11 |