| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
802 |
786 |
$30K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
202 |
202 |
$17K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
201 |
201 |
$17K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
971 |
970 |
$10K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
65 |
65 |
$5K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
521 |
514 |
$5K |
| 94010 |
|
108 |
108 |
$4K |
| 90688 |
|
176 |
176 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
21 |
21 |
$2K |
| 94664 |
|
70 |
70 |
$746.58 |
| 90698 |
|
47 |
47 |
$484.15 |
| 90670 |
|
41 |
41 |
$294.40 |
| 90685 |
|
14 |
14 |
$261.01 |
| 90651 |
|
25 |
25 |
$220.80 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
17 |
13 |
$192.44 |
| 90474 |
|
19 |
19 |
$171.76 |
| 96160 |
|
41 |
41 |
$145.95 |
| 92551 |
|
12 |
12 |
$112.64 |
| 96161 |
|
18 |
18 |
$75.06 |
| 90744 |
|
15 |
15 |
$26.90 |
| 90686 |
|
63 |
63 |
$19.03 |
| 90734 |
|
12 |
12 |
$5.75 |
| 3008F |
|
698 |
697 |
$0.00 |
| 90680 |
|
16 |
16 |
$0.00 |
| 2014F |
|
264 |
264 |
$0.00 |