| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,934 |
2,614 |
$108K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
2,092 |
1,950 |
$46K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
605 |
576 |
$38K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
638 |
574 |
$35K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
395 |
376 |
$24K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,636 |
1,535 |
$18K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,009 |
953 |
$15K |
| 92552 |
|
805 |
752 |
$11K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
424 |
372 |
$10K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
151 |
140 |
$10K |
| 99173 |
|
793 |
747 |
$4K |
| 3008F |
|
494 |
479 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
13 |
13 |
$822.02 |
| 90474 |
|
80 |
75 |
$592.16 |
| 90658 |
|
132 |
127 |
$0.70 |
| 90686 |
|
77 |
77 |
$0.02 |
| 90657 |
|
105 |
98 |
$0.00 |
| 90723 |
|
44 |
41 |
$0.00 |
| 90680 |
|
127 |
115 |
$0.00 |
| 90716 |
|
42 |
39 |
$0.00 |
| 90688 |
|
57 |
57 |
$0.00 |
| 90670 |
|
413 |
390 |
$0.00 |
| 90648 |
|
169 |
160 |
$0.00 |
| Q2038 |
Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluzone) |
28 |
24 |
$0.00 |
| 90707 |
|
53 |
50 |
$0.00 |
| 90633 |
|
74 |
69 |
$0.00 |