| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,490 |
1,448 |
$126K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,292 |
1,292 |
$114K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
962 |
918 |
$66K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,420 |
1,415 |
$36K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,955 |
1,936 |
$36K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
401 |
401 |
$35K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
739 |
709 |
$34K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
2,803 |
2,713 |
$23K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
42 |
42 |
$4K |
| 99460 |
|
37 |
37 |
$3K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
43 |
43 |
$3K |
| 90474 |
|
148 |
148 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
43 |
43 |
$2K |
| 99215 |
Prolong outpt/office vis |
13 |
12 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
54 |
53 |
$1K |
| 90473 |
|
68 |
68 |
$1K |
| 96161 |
|
180 |
167 |
$860.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
47 |
46 |
$793.38 |
| 96127 |
|
119 |
119 |
$460.17 |
| 83655 |
|
39 |
39 |
$387.72 |
| 99188 |
|
24 |
24 |
$235.40 |
| 87807 |
|
13 |
12 |
$126.30 |
| 85018 |
|
37 |
37 |
$71.74 |
| 90656 |
|
36 |
36 |
$0.10 |
| 90686 |
|
257 |
256 |
$0.01 |
| 90723 |
|
131 |
131 |
$0.00 |
| 90697 |
|
36 |
36 |
$0.00 |
| 90674 |
|
15 |
15 |
$0.00 |
| 90716 |
|
13 |
13 |
$0.00 |
| 90698 |
|
12 |
12 |
$0.00 |
| 90648 |
|
259 |
259 |
$0.00 |
| 96160 |
|
115 |
115 |
$0.00 |
| 90670 |
|
515 |
515 |
$0.00 |
| 90681 |
|
193 |
193 |
$0.00 |
| 90672 |
|
59 |
59 |
$0.00 |
| 90671 |
|
194 |
194 |
$0.00 |
| 90633 |
|
70 |
70 |
$0.00 |