| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
89 |
85 |
$5K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
32 |
31 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
20 |
20 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
18 |
18 |
$1K |
| 92551 |
|
25 |
25 |
$244.56 |
| 90710 |
|
12 |
12 |
$219.60 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
17 |
17 |
$0.00 |