| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,184 |
1,067 |
$68K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
347 |
322 |
$29K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
255 |
255 |
$21K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
244 |
242 |
$19K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
140 |
140 |
$11K |
| 90670 |
|
227 |
227 |
$4K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
428 |
428 |
$3K |
| 90723 |
|
179 |
179 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
19 |
19 |
$2K |
| 90647 |
|
166 |
166 |
$2K |
| 90633 |
|
124 |
124 |
$1K |
| 90681 |
|
86 |
86 |
$1K |
| 90716 |
|
56 |
56 |
$975.95 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
481 |
479 |
$790.44 |
| 90461 |
|
368 |
367 |
$771.35 |
| 90734 |
|
31 |
31 |
$768.65 |
| 90651 |
|
54 |
54 |
$742.98 |
| 90686 |
|
67 |
67 |
$656.23 |
| 99173 |
|
249 |
232 |
$562.03 |
| 90707 |
|
44 |
44 |
$462.04 |
| 90715 |
|
41 |
40 |
$456.44 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
27 |
27 |
$57.75 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
19 |
19 |
$57.75 |