| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,000 |
945 |
$29K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
926 |
874 |
$22K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
925 |
830 |
$20K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,505 |
1,483 |
$12K |
| 92552 |
|
1,697 |
1,620 |
$11K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,047 |
681 |
$8K |
| 96156 |
|
103 |
102 |
$3K |
| 99173 |
|
1,528 |
1,505 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
82 |
66 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,461 |
5,151 |
$835.24 |
| 85018 |
|
662 |
611 |
$830.60 |
| 90651 |
|
241 |
222 |
$207.00 |
| 90633 |
|
135 |
125 |
$144.00 |
| 81000 |
|
96 |
96 |
$131.58 |
| 90670 |
|
61 |
55 |
$117.00 |
| 90716 |
|
70 |
65 |
$108.00 |
| 81003 |
|
183 |
172 |
$107.72 |
| 90658 |
|
131 |
116 |
$90.00 |
| 90734 |
|
183 |
180 |
$63.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
14 |
14 |
$56.56 |
| 90707 |
|
46 |
41 |
$54.00 |
| 90715 |
|
29 |
29 |
$18.00 |
| 90686 |
|
24 |
17 |
$9.00 |
| 87077 |
|
611 |
602 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
579 |
558 |
$0.00 |
| 97803 |
|
12 |
12 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
12 |
12 |
$0.00 |
| 90700 |
|
12 |
12 |
$0.00 |