| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,466 |
1,170 |
$69K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
502 |
448 |
$38K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
28 |
26 |
$3K |
| 99384 |
|
12 |
12 |
$1K |
| 99173 |
|
69 |
64 |
$484.25 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
32 |
29 |
$482.10 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
55 |
55 |
$453.04 |
| 90461 |
|
12 |
12 |
$244.50 |