| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
857 |
837 |
$34K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
334 |
334 |
$27K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
137 |
137 |
$12K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
990 |
989 |
$10K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
65 |
65 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
37 |
37 |
$3K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
393 |
393 |
$3K |
| 90686 |
|
361 |
361 |
$2K |
| 90633 |
|
66 |
66 |
$927.60 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
70 |
57 |
$611.28 |
| 90685 |
|
33 |
33 |
$607.20 |
| 90698 |
|
56 |
56 |
$570.40 |
| 90670 |
|
52 |
52 |
$257.60 |
| 99177 |
|
39 |
39 |
$36.40 |
| 3008F |
|
668 |
668 |
$0.00 |
| 2014F |
|
206 |
206 |
$0.00 |