| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,646 |
2,488 |
$220K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,484 |
3,187 |
$214K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,711 |
1,709 |
$161K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,344 |
2,343 |
$125K |
| 90461 |
|
1,794 |
1,794 |
$71K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,042 |
1,033 |
$20K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
378 |
378 |
$10K |
| 99382 |
|
47 |
47 |
$6K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
55 |
55 |
$5K |
| 99188 |
|
287 |
286 |
$4K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
38 |
38 |
$3K |
| 99460 |
|
28 |
28 |
$2K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
32 |
31 |
$2K |
| 90474 |
|
113 |
113 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
13 |
13 |
$1K |
| 0071A |
|
27 |
14 |
$510.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
32 |
32 |
$461.90 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
25 |
25 |
$157.76 |
| 36416 |
|
15 |
12 |
$45.00 |
| 90723 |
|
1,088 |
1,088 |
$0.00 |
| 90647 |
|
1,072 |
1,071 |
$0.00 |
| 90686 |
|
1,026 |
1,019 |
$0.00 |
| 91307 |
|
44 |
26 |
$0.00 |
| 96161 |
|
17 |
17 |
$0.00 |
| 90716 |
|
46 |
46 |
$0.00 |
| 90681 |
|
613 |
613 |
$0.00 |
| 90707 |
|
59 |
59 |
$0.00 |
| 90633 |
|
381 |
379 |
$0.00 |
| 90670 |
|
1,500 |
1,499 |
$0.00 |
| 90700 |
|
28 |
28 |
$0.00 |