| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,209 |
2,368 |
$192K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
170 |
154 |
$14K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
179 |
178 |
$13K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
847 |
842 |
$8K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
715 |
677 |
$6K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
67 |
66 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
29 |
29 |
$2K |
| 81002 |
|
775 |
767 |
$2K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
14 |
14 |
$203.56 |
| 90688 |
|
75 |
75 |
$93.34 |
| 96127 |
|
32 |
32 |
$89.96 |
| 97803 |
|
363 |
362 |
$0.00 |
| 90661 |
|
15 |
15 |
$0.00 |