| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,533 |
2,193 |
$150K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,963 |
1,824 |
$85K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
213 |
211 |
$18K |
| 94200 |
|
1,413 |
1,204 |
$15K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
120 |
120 |
$12K |
| 94664 |
|
734 |
662 |
$12K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
124 |
124 |
$10K |
| 99188 |
|
518 |
491 |
$9K |
| 90672 |
|
511 |
508 |
$5K |
| 96127 |
|
866 |
862 |
$4K |
| 92552 |
|
172 |
169 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
311 |
288 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
316 |
308 |
$2K |
| 99080 |
|
66 |
66 |
$1K |
| 99499 |
|
50 |
45 |
$1K |
| 90473 |
|
134 |
132 |
$1K |
| 90686 |
|
84 |
84 |
$791.50 |
| 90700 |
|
84 |
84 |
$640.00 |
| 90688 |
|
66 |
66 |
$520.86 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
61 |
61 |
$449.10 |
| 90685 |
|
43 |
43 |
$370.00 |
| 90647 |
|
51 |
51 |
$360.00 |
| 99173 |
|
174 |
171 |
$317.82 |
| 90674 |
|
18 |
18 |
$182.00 |
| 90713 |
|
13 |
13 |
$130.00 |
| 94760 |
|
753 |
673 |
$11.76 |