| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
797 |
691 |
$31K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
463 |
415 |
$23K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
860 |
822 |
$21K |
| 92567 |
|
554 |
547 |
$5K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
881 |
868 |
$5K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
65 |
65 |
$4K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
25 |
25 |
$1K |
| 99173 |
|
334 |
333 |
$650.40 |
| 92587 |
|
25 |
25 |
$346.89 |
| 81002 |
|
117 |
117 |
$208.26 |
| 81000 |
|
17 |
17 |
$37.40 |