| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,121 |
928 |
$60K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
461 |
406 |
$36K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
140 |
137 |
$20K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
66 |
65 |
$9K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
898 |
793 |
$7K |
| 90461 |
|
188 |
184 |
$168.03 |
| 99173 |
|
94 |
90 |
$20.00 |
| 90670 |
|
27 |
26 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
27 |
25 |
$0.00 |
| 92551 |
|
95 |
92 |
$0.00 |
| 90686 |
|
90 |
87 |
$0.00 |
| 3008F |
|
49 |
48 |
$0.00 |
| 90688 |
|
61 |
58 |
$0.00 |