| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,374 |
3,917 |
$263K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
926 |
829 |
$76K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,595 |
2,506 |
$57K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
529 |
520 |
$42K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
450 |
440 |
$34K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
214 |
211 |
$19K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
415 |
408 |
$13K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
88 |
80 |
$5K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
716 |
668 |
$3K |
| 90686 |
|
611 |
599 |
$620.49 |
| 99051 |
|
136 |
130 |
$499.26 |
| 90672 |
|
160 |
159 |
$326.08 |
| 99429 |
|
13 |
13 |
$242.50 |
| 90480 |
|
12 |
12 |
$163.29 |
| 91307 |
|
14 |
12 |
$13.70 |
| 36416 |
|
12 |
12 |
$2.38 |
| 90734 |
|
13 |
13 |
$0.00 |
| 90670 |
|
26 |
26 |
$0.00 |
| 90698 |
|
12 |
12 |
$0.00 |