| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,220 |
875 |
$100K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,386 |
978 |
$69K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
729 |
637 |
$32K |
| 99050 |
|
278 |
208 |
$13K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
915 |
688 |
$12K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
69 |
26 |
$6K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
66 |
43 |
$5K |
| 96161 |
|
506 |
433 |
$568.45 |
| 90461 |
|
40 |
24 |
$337.02 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
17 |
12 |
$207.05 |
| 99173 |
|
495 |
441 |
$75.28 |
| 99401 |
|
173 |
117 |
$40.76 |
| 3008F |
|
568 |
488 |
$20.95 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
113 |
105 |
$0.00 |
| 90686 |
|
36 |
28 |
$0.00 |
| 99000 |
|
55 |
52 |
$0.00 |
| 96127 |
|
42 |
28 |
$0.00 |
| 96160 |
|
236 |
183 |
$0.00 |
| 3725F |
|
33 |
28 |
$0.00 |