| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
117 |
112 |
$7K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
84 |
72 |
$6K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
41 |
35 |
$4K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
30 |
30 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
149 |
138 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
60 |
60 |
$1K |
| 90461 |
|
58 |
33 |
$1K |
| 99173 |
|
82 |
82 |
$615.00 |
| 92587 |
|
85 |
84 |
$445.54 |
| 96127 |
|
15 |
15 |
$75.30 |
| 36416 |
|
13 |
13 |
$39.00 |
| 99000 |
|
12 |
12 |
$0.00 |