| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
715 |
704 |
$7K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
516 |
511 |
$6K |
| 92552 |
|
385 |
380 |
$4K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,606 |
1,558 |
$3K |
| 87110 |
|
152 |
151 |
$2K |
| 82947 |
|
386 |
382 |
$1K |
| 82465 |
|
370 |
367 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,549 |
2,408 |
$1K |
| 99173 |
|
359 |
356 |
$904.80 |
| 81003 |
|
351 |
351 |
$832.30 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
263 |
255 |
$832.24 |
| 83026 |
|
326 |
326 |
$826.22 |
| 86580 |
|
324 |
319 |
$589.79 |
| 86592 |
|
144 |
143 |
$490.24 |
| 92551 |
|
268 |
264 |
$434.18 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
216 |
216 |
$264.40 |
| 90686 |
|
964 |
904 |
$173.08 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
14 |
12 |
$105.08 |
| 85018 |
|
49 |
47 |
$81.00 |
| 85014 |
|
50 |
48 |
$59.83 |
| 90734 |
|
216 |
208 |
$45.24 |
| 90651 |
|
172 |
167 |
$45.12 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
56 |
56 |
$44.80 |
| 90672 |
|
18 |
17 |
$0.02 |