| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
613 |
580 |
$9K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
205 |
195 |
$7K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
198 |
198 |
$4K |
| 90686 |
|
152 |
152 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
52 |
52 |
$1K |
| 96127 |
|
135 |
132 |
$1K |
| 90670 |
|
26 |
26 |
$570.96 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
113 |
113 |
$495.60 |
| 99173 |
|
115 |
114 |
$399.60 |
| 96160 |
|
80 |
80 |
$352.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
83 |
74 |
$337.20 |
| 90723 |
|
12 |
12 |
$263.52 |
| 90685 |
|
13 |
13 |
$263.52 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
27 |
27 |
$240.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
16 |
16 |
$119.60 |
| 99174 |
|
14 |
14 |
$0.00 |
| 99177 |
|
17 |
17 |
$0.00 |