| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
657 |
520 |
$33K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
249 |
195 |
$19K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
424 |
369 |
$7K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
119 |
107 |
$5K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
60 |
56 |
$4K |
| S0281 |
Medical home program, comprehensive care coordination and planning, maintenance of plan |
932 |
906 |
$3K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
22 |
19 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
30 |
27 |
$2K |
| 99383 |
|
14 |
12 |
$981.97 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
15 |
14 |
$591.60 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
14 |
12 |
$471.60 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
43 |
26 |
$167.75 |
| 96127 |
|
20 |
16 |
$86.55 |
| 90656 |
|
17 |
16 |
$0.00 |
| 90677 |
|
17 |
12 |
$0.00 |
| 99173 |
|
36 |
33 |
$0.00 |
| 90648 |
|
19 |
14 |
$0.00 |
| 90715 |
|
15 |
12 |
$0.00 |