| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,264 |
1,262 |
$39K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
830 |
828 |
$30K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,060 |
1,057 |
$30K |
| 92552 |
|
2,142 |
2,140 |
$24K |
| 99460 |
|
536 |
535 |
$23K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,812 |
2,925 |
$21K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
12,346 |
10,351 |
$17K |
| 99462 |
|
599 |
526 |
$11K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
249 |
246 |
$9K |
| 90686 |
|
1,181 |
1,178 |
$7K |
| 99381 |
|
50 |
50 |
$5K |
| 0003A |
|
95 |
95 |
$4K |
| 0071A |
|
84 |
84 |
$3K |
| 0072A |
|
78 |
78 |
$3K |
| 99173 |
|
1,497 |
1,496 |
$2K |
| 90700 |
|
403 |
401 |
$2K |
| 90670 |
|
301 |
298 |
$1K |
| 90648 |
|
241 |
238 |
$1K |
| 90620 |
|
183 |
183 |
$821.00 |
| 0001A |
|
15 |
15 |
$600.00 |
| 90685 |
|
113 |
113 |
$599.00 |
| 90649 |
|
194 |
194 |
$581.00 |
| 0004A |
|
14 |
14 |
$560.00 |
| 90713 |
|
128 |
127 |
$495.00 |
| 0002A |
|
12 |
12 |
$480.00 |
| 90710 |
|
91 |
91 |
$408.00 |
| 90656 |
|
84 |
84 |
$396.00 |
| 90633 |
|
77 |
76 |
$351.00 |
| 90680 |
|
24 |
24 |
$207.00 |
| 90715 |
|
13 |
13 |
$27.00 |
| 90658 |
|
323 |
321 |
$0.00 |
| 92551 |
|
209 |
209 |
$0.00 |
| 92499 |
|
175 |
175 |
$0.00 |
| 90733 |
|
30 |
28 |
$0.00 |