| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
845 |
837 |
$5K |
| D0191 |
|
274 |
272 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
304 |
301 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,936 |
2,767 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
481 |
439 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
133 |
129 |
$927.30 |
| 90686 |
|
31 |
31 |
$316.16 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
56 |
56 |
$114.51 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
2,100 |
1,782 |
$113.40 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,975 |
1,654 |
$40.37 |
| 90672 |
|
29 |
28 |
$21.96 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
110 |
100 |
$21.33 |
| 96127 |
|
716 |
496 |
$17.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
249 |
243 |
$15.67 |
| 90680 |
|
25 |
25 |
$0.00 |
| 90647 |
|
53 |
53 |
$0.00 |
| 90474 |
|
12 |
12 |
$0.00 |
| 0001A |
|
23 |
23 |
$0.00 |
| 36416 |
|
26 |
25 |
$0.00 |
| 90651 |
|
13 |
12 |
$0.00 |
| 90461 |
|
1,144 |
910 |
$0.00 |
| 96160 |
|
349 |
343 |
$0.00 |
| 90670 |
|
129 |
126 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
486 |
274 |
$0.00 |
| 99173 |
|
44 |
44 |
$0.00 |
| 91300 |
|
85 |
78 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
13 |
13 |
$0.00 |
| 99188 |
|
31 |
31 |
$0.00 |
| 90633 |
|
12 |
12 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
48 |
45 |
$0.00 |
| 90715 |
|
12 |
12 |
$0.00 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
25 |
25 |
$0.00 |