| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
748 |
679 |
$38K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
205 |
196 |
$6K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
278 |
268 |
$5K |
| 99401 |
|
113 |
107 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
12 |
12 |
$638.28 |
| 85018 |
|
195 |
191 |
$308.31 |
| 81002 |
|
95 |
91 |
$211.14 |
| 90461 |
|
18 |
15 |
$24.00 |
| 99072 |
|
82 |
77 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
76 |
72 |
$0.00 |
| 90686 |
|
26 |
24 |
$0.00 |