| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,409 |
1,926 |
$144K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
530 |
463 |
$51K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
102 |
100 |
$12K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
26 |
26 |
$4K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
34 |
25 |
$3K |
| 92552 |
|
249 |
249 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
290 |
284 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
73 |
73 |
$882.68 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
160 |
146 |
$672.28 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
12 |
12 |
$144.00 |
| 90461 |
|
24 |
24 |
$6.63 |
| 90686 |
|
64 |
62 |
$0.00 |
| 90677 |
|
14 |
14 |
$0.00 |
| 99173 |
|
270 |
257 |
$0.00 |
| 99188 |
|
12 |
12 |
$0.00 |