| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,107 |
1,003 |
$94K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,203 |
1,085 |
$80K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
814 |
775 |
$15K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
76 |
74 |
$9K |
| 96161 |
|
563 |
486 |
$7K |
| 99050 |
|
235 |
216 |
$6K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
42 |
41 |
$4K |
| 90461 |
|
112 |
92 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$1K |
| 96160 |
|
256 |
246 |
$981.56 |
| 92552 |
|
31 |
27 |
$646.10 |
| 0071A |
|
12 |
12 |
$576.83 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
39 |
32 |
$395.25 |
| 99401 |
|
77 |
71 |
$372.00 |
| 96127 |
|
115 |
106 |
$51.86 |
| 90686 |
|
27 |
27 |
$20.00 |
| 3008F |
|
50 |
49 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
17 |
17 |
$0.00 |
| 90656 |
|
12 |
12 |
$0.00 |
| 99173 |
|
18 |
17 |
$0.00 |