| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
2,900 |
2,788 |
$226K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,684 |
2,543 |
$215K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
2,479 |
2,313 |
$181K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,453 |
1,378 |
$112K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
7,658 |
2,619 |
$17K |
| 99381 |
|
179 |
172 |
$14K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
3,089 |
2,540 |
$7K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
49 |
49 |
$4K |
| 90461 |
|
2,476 |
1,976 |
$4K |
| 97169 |
|
77 |
70 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
76 |
72 |
$2K |
| 90677 |
|
259 |
258 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
892 |
876 |
$2K |
| 99384 |
|
17 |
17 |
$1K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
734 |
387 |
$995.10 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
15 |
12 |
$7.25 |
| 90651 |
|
275 |
265 |
$0.05 |
| 90716 |
|
636 |
627 |
$0.00 |
| 90680 |
|
595 |
587 |
$0.00 |
| 90723 |
|
379 |
373 |
$0.00 |
| 90697 |
|
262 |
252 |
$0.00 |
| 90698 |
|
141 |
141 |
$0.00 |
| 90696 |
|
221 |
220 |
$0.00 |
| 90633 |
|
651 |
634 |
$0.00 |
| 90670 |
|
1,113 |
1,076 |
$0.00 |
| 90707 |
|
632 |
617 |
$0.00 |
| 90658 |
|
319 |
303 |
$0.00 |
| 90734 |
|
476 |
459 |
$0.00 |
| 90700 |
|
174 |
171 |
$0.00 |
| 90655 |
|
53 |
53 |
$0.00 |
| 90648 |
|
615 |
605 |
$0.00 |
| 90710 |
|
12 |
12 |
$0.00 |
| 90681 |
|
146 |
133 |
$0.00 |
| 90715 |
|
224 |
224 |
$0.00 |