| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,013 |
860 |
$67K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
374 |
370 |
$6K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
39 |
39 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
33 |
33 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
26 |
25 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
226 |
224 |
$809.48 |
| 92551 |
|
251 |
251 |
$384.53 |
| 96160 |
|
17 |
17 |
$30.77 |
| 99173 |
|
250 |
247 |
$16.94 |
| 90686 |
|
15 |
15 |
$0.00 |