| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,206 |
1,006 |
$55K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
113 |
100 |
$8K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
90 |
83 |
$7K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
63 |
40 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
44 |
40 |
$4K |
| 90686 |
|
156 |
138 |
$1K |
| 81003 |
|
490 |
424 |
$1K |
| 85018 |
|
464 |
399 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
29 |
27 |
$742.45 |
| 99173 |
|
97 |
93 |
$700.30 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
29 |
26 |
$434.02 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
511 |
349 |
$151.39 |
| 90461 |
|
32 |
27 |
$55.20 |
| 1160F |
|
2,101 |
1,664 |
$0.00 |
| 1159F |
|
2,073 |
1,641 |
$0.00 |
| 1003F |
|
225 |
189 |
$0.00 |
| 1036F |
|
28 |
27 |
$0.00 |
| 1220F |
|
27 |
26 |
$0.00 |