| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
462 |
437 |
$34K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
109 |
107 |
$10K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
318 |
311 |
$6K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
61 |
59 |
$5K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
537 |
528 |
$5K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
271 |
260 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
30 |
30 |
$3K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
226 |
173 |
$2K |
| 96127 |
|
182 |
179 |
$2K |
| 83655 |
|
12 |
12 |
$128.16 |
| 90661 |
|
96 |
93 |
$0.00 |
| 90648 |
|
26 |
26 |
$0.00 |
| 90670 |
|
13 |
13 |
$0.00 |