| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
218 |
203 |
$71.58 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
47 |
47 |
$0.00 |
| 99401 |
|
79 |
78 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
190 |
163 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
96 |
95 |
$0.00 |
| 99173 |
|
293 |
292 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
89 |
89 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
38 |
38 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
16 |
13 |
$0.00 |
| 92583 |
|
52 |
52 |
$0.00 |
| 90686 |
|
56 |
55 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
53 |
47 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
19 |
19 |
$0.00 |