| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
205 |
203 |
$12K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
117 |
117 |
$8K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
62 |
62 |
$6K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
123 |
123 |
$3K |
| 92552 |
|
83 |
83 |
$2K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
39 |
37 |
$2K |
| 99243 |
|
14 |
14 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
13 |
13 |
$1K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
14 |
14 |
$1K |
| 99188 |
|
16 |
16 |
$376.00 |
| 96127 |
|
74 |
74 |
$349.55 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
35 |
23 |
$269.98 |
| 90461 |
|
13 |
13 |
$112.48 |
| 86580 |
|
15 |
15 |
$105.48 |
| 83655 |
|
12 |
12 |
$56.49 |
| 99173 |
|
13 |
13 |
$34.57 |
| 81003 |
|
37 |
37 |
$9.86 |
| 36416 |
|
15 |
15 |
$0.00 |
| 3079F |
|
12 |
12 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
13 |
13 |
$0.00 |
| 3074F |
|
14 |
14 |
$0.00 |