| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
191 |
188 |
$11K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
139 |
137 |
$10K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
83 |
83 |
$7K |
| 90670 |
|
99 |
97 |
$1K |
| 90648 |
|
90 |
88 |
$979.16 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
21 |
19 |
$599.59 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
231 |
225 |
$503.62 |
| 90686 |
|
35 |
34 |
$359.87 |
| 90723 |
|
27 |
27 |
$351.37 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
32 |
32 |
$271.04 |
| 90461 |
|
167 |
165 |
$226.28 |
| 83655 |
|
15 |
15 |
$220.05 |
| 90633 |
|
12 |
12 |
$154.63 |
| 99173 |
|
28 |
27 |
$64.75 |
| 85018 |
|
12 |
12 |
$34.56 |
| 36416 |
|
17 |
17 |
$18.70 |