| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
179 |
153 |
$16K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
239 |
205 |
$14K |
| 99215 |
Prolong outpt/office vis |
56 |
50 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
41 |
32 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
45 |
43 |
$3K |
| 90661 |
|
37 |
37 |
$618.27 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
28 |
26 |
$434.12 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
28 |
28 |
$252.56 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
61 |
57 |
$0.00 |