| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 96127 |
|
518 |
429 |
$9K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
93 |
86 |
$6K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
37 |
12 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
31 |
12 |
$2K |
| 99173 |
|
176 |
156 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
25 |
24 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
53 |
52 |
$916.38 |
| 90686 |
|
25 |
25 |
$172.63 |
| 36416 |
|
17 |
14 |
$57.40 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
154 |
140 |
$0.00 |