| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
158 |
153 |
$11K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
68 |
68 |
$7K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
16 |
16 |
$2K |
| 90461 |
|
66 |
66 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
107 |
107 |
$1K |
| 96127 |
|
110 |
105 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
88 |
88 |
$817.65 |
| 96161 |
|
61 |
61 |
$398.10 |
| 85018 |
|
145 |
145 |
$291.10 |
| 99188 |
|
12 |
12 |
$194.40 |
| 96160 |
|
14 |
14 |
$85.00 |
| 90686 |
|
30 |
30 |
$0.00 |