| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,372 |
1,345 |
$26K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
402 |
401 |
$15K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,329 |
2,092 |
$13K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
314 |
314 |
$12K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
168 |
167 |
$6K |
| 90461 |
|
312 |
308 |
$5K |
| 90686 |
|
126 |
126 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
228 |
228 |
$1K |
| 86580 |
|
237 |
237 |
$1K |
| 99173 |
|
693 |
693 |
$370.17 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
91 |
90 |
$153.03 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
25 |
25 |
$29.45 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
154 |
153 |
$0.00 |
| 99058 |
|
189 |
184 |
$0.00 |