| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,967 |
1,839 |
$95K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
430 |
429 |
$30K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,094 |
1,079 |
$29K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
404 |
403 |
$26K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,106 |
1,101 |
$15K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
428 |
427 |
$6K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
84 |
84 |
$6K |
| 90461 |
|
246 |
245 |
$5K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
77 |
77 |
$5K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
49 |
48 |
$3K |
| 3008F |
|
1,074 |
1,071 |
$2K |
| 99173 |
|
656 |
655 |
$1K |
| 99442 |
|
14 |
14 |
$475.06 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
39 |
39 |
$464.93 |
| 90686 |
|
28 |
28 |
$333.43 |
| 99070 |
|
29 |
29 |
$0.00 |
| 99072 |
|
25 |
25 |
$0.00 |