| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
418 |
402 |
$23K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
114 |
110 |
$9K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
298 |
286 |
$6K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
73 |
72 |
$6K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
57 |
57 |
$5K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
31 |
31 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
104 |
101 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
169 |
167 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
12 |
12 |
$851.20 |
| 90686 |
|
204 |
199 |
$659.89 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
35 |
34 |
$202.92 |
| 90651 |
|
17 |
17 |
$184.00 |
| 99173 |
|
225 |
223 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
231 |
226 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
713 |
684 |
$0.00 |
| 92551 |
|
198 |
196 |
$0.00 |