| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,041 |
632 |
$42K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,303 |
556 |
$24K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
241 |
146 |
$12K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
103 |
71 |
$6K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
116 |
78 |
$6K |
| 90461 |
|
397 |
231 |
$5K |
| 99223 |
Prolong inpt eval add15 m |
53 |
40 |
$3K |
| 92557 |
|
181 |
126 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
321 |
111 |
$2K |
| 99177 |
|
202 |
129 |
$2K |
| 90671 |
|
39 |
26 |
$738.64 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
15 |
12 |
$658.05 |
| 90674 |
|
130 |
55 |
$309.97 |
| 99239 |
Hospital discharge day management, more than 30 minutes |
18 |
13 |
$274.59 |
| 99233 |
Prolong inpt eval add15 m |
35 |
18 |
$274.43 |
| 90677 |
|
125 |
76 |
$0.15 |
| 90661 |
|
122 |
91 |
$0.15 |
| 90698 |
|
60 |
40 |
$0.07 |
| 90680 |
|
56 |
38 |
$0.07 |
| 90633 |
|
18 |
12 |
$0.04 |
| 90744 |
|
19 |
12 |
$0.00 |