| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
960 |
885 |
$31K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
26 |
26 |
$2K |
| 90686 |
|
102 |
100 |
$839.82 |
| 92552 |
|
110 |
108 |
$736.60 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
12 |
12 |
$587.72 |
| 90670 |
|
81 |
80 |
$459.00 |
| 90723 |
|
59 |
59 |
$396.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
48 |
27 |
$319.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
28 |
24 |
$169.18 |
| 90710 |
|
15 |
15 |
$129.00 |
| 90647 |
|
15 |
15 |
$121.00 |
| 99173 |
|
13 |
12 |
$59.40 |
| 96127 |
|
12 |
12 |
$44.00 |