| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
319 |
117 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
628 |
297 |
$748.30 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
31 |
24 |
$107.55 |
| 96127 |
|
454 |
272 |
$56.52 |
| 90686 |
|
76 |
55 |
$23.28 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
40 |
28 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
24 |
16 |
$0.00 |
| 90670 |
|
15 |
13 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
47 |
29 |
$0.00 |
| 90698 |
|
17 |
15 |
$0.00 |