| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,739 |
2,433 |
$167K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
703 |
628 |
$10K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
53 |
51 |
$3K |
| 90686 |
|
132 |
126 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
61 |
59 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
14 |
14 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
36 |
35 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
15 |
15 |
$847.14 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
13 |
12 |
$615.93 |
| 99173 |
|
88 |
77 |
$110.96 |
| 97802 |
|
50 |
42 |
$0.00 |