| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
587 |
509 |
$10K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
575 |
520 |
$10K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,054 |
887 |
$9K |
| 90670 |
|
248 |
221 |
$5K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
275 |
255 |
$4K |
| 90723 |
|
185 |
163 |
$4K |
| 90647 |
|
161 |
145 |
$3K |
| 90686 |
|
137 |
134 |
$3K |
| 90680 |
|
130 |
111 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
53 |
53 |
$2K |
| 90633 |
|
76 |
63 |
$1K |
| 96127 |
|
111 |
101 |
$720.00 |
| 90685 |
|
42 |
33 |
$680.76 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
292 |
245 |
$673.60 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
60 |
53 |
$597.20 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
13 |
13 |
$488.00 |
| 96160 |
|
112 |
102 |
$431.20 |
| 90688 |
|
13 |
13 |
$241.56 |
| 99188 |
|
15 |
14 |
$181.58 |
| 94760 |
|
14 |
12 |
$3.20 |
| 99174 |
|
56 |
56 |
$0.00 |