| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
898 |
736 |
$47K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,119 |
945 |
$39K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
74 |
67 |
$6K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
61 |
61 |
$6K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
13 |
13 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
12 |
12 |
$1K |
| 0001A |
|
17 |
16 |
$360.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
155 |
149 |
$118.76 |
| 92552 |
|
60 |
57 |
$41.20 |
| 90633 |
|
12 |
12 |
$10.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
88 |
74 |
$0.00 |
| 99173 |
|
95 |
83 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
351 |
345 |
$0.00 |
| 90686 |
|
16 |
16 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
13 |
13 |
$0.00 |