| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
2,593 |
2,589 |
$63K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
2,137 |
2,137 |
$59K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,591 |
1,583 |
$40K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,648 |
4,394 |
$25K |
| 92552 |
|
2,351 |
2,347 |
$23K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,039 |
1,843 |
$22K |
| 92551 |
|
4,046 |
4,045 |
$18K |
| 90686 |
|
4,167 |
4,163 |
$16K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,394 |
1,389 |
$9K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
158 |
158 |
$7K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,629 |
2,517 |
$7K |
| 99173 |
|
3,393 |
3,391 |
$5K |
| 90480 |
|
76 |
69 |
$3K |
| 97803 |
|
1,418 |
1,417 |
$2K |
| 0072A |
|
49 |
45 |
$2K |
| 90670 |
|
465 |
465 |
$2K |
| 90651 |
|
718 |
718 |
$1K |
| 90647 |
|
289 |
289 |
$1K |
| 0154A |
|
31 |
29 |
$1K |
| 97804 |
|
1,537 |
1,537 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
40 |
40 |
$1K |
| 90674 |
|
172 |
172 |
$965.00 |
| 0071A |
|
36 |
27 |
$920.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
177 |
176 |
$811.62 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
142 |
111 |
$782.42 |
| 90723 |
|
168 |
168 |
$621.00 |
| 0081A |
|
21 |
15 |
$600.00 |
| 90685 |
|
69 |
69 |
$552.00 |
| 0082A |
|
12 |
12 |
$480.00 |
| 90633 |
|
125 |
125 |
$368.55 |
| 90734 |
|
238 |
238 |
$261.00 |
| 90715 |
|
135 |
135 |
$197.10 |
| 90681 |
|
27 |
27 |
$153.00 |
| 90716 |
|
13 |
13 |
$81.00 |
| 85018 |
|
26 |
25 |
$49.69 |
| 90619 |
|
12 |
12 |
$36.00 |
| 99442 |
|
49 |
49 |
$0.00 |
| 90461 |
|
14 |
12 |
$0.00 |