| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,636 |
1,388 |
$185K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,917 |
2,230 |
$182K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,703 |
923 |
$134K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
3,369 |
1,839 |
$55K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
600 |
288 |
$47K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
433 |
265 |
$31K |
| 90686 |
|
1,577 |
926 |
$11K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
128 |
60 |
$11K |
| 90670 |
|
1,036 |
552 |
$10K |
| 90680 |
|
635 |
337 |
$4K |
| 90651 |
|
229 |
97 |
$4K |
| 90723 |
|
353 |
260 |
$3K |
| 90633 |
|
365 |
185 |
$2K |
| 90647 |
|
348 |
249 |
$2K |
| 90698 |
|
303 |
112 |
$2K |
| 90710 |
|
101 |
42 |
$1K |
| 90744 |
|
190 |
71 |
$1K |
| 99460 |
|
14 |
14 |
$549.46 |
| 99238 |
Hospital discharge day management, 30 minutes or less |
15 |
15 |
$423.11 |
| 90685 |
|
60 |
33 |
$395.21 |
| 90734 |
|
60 |
28 |
$374.30 |
| 99174 |
|
34 |
13 |
$252.23 |
| 90700 |
|
35 |
12 |
$230.27 |
| 90715 |
|
30 |
12 |
$196.94 |
| 90696 |
|
28 |
13 |
$151.38 |
| 90461 |
|
1,359 |
657 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,694 |
1,344 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
87 |
83 |
$0.00 |