| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
315 |
272 |
$17K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
59 |
56 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
28 |
27 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
22 |
20 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
17 |
15 |
$1K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
59 |
58 |
$210.00 |
| 81002 |
|
78 |
75 |
$20.76 |
| 90658 |
|
14 |
14 |
$10.00 |
| 97803 |
|
332 |
328 |
$0.00 |
| 99173 |
|
130 |
105 |
$0.00 |
| 99000 |
|
115 |
89 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
240 |
197 |
$0.00 |
| 92551 |
|
114 |
92 |
$0.00 |