| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
417 |
401 |
$19K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
116 |
108 |
$8K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
99 |
83 |
$8K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
29 |
29 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
70 |
61 |
$1K |
| 90686 |
|
61 |
46 |
$1K |
| 90670 |
|
14 |
14 |
$175.84 |
| 90648 |
|
13 |
13 |
$163.28 |
| 36415 |
Collection of venous blood by venipuncture |
30 |
30 |
$0.00 |