| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
233 |
225 |
$12K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
230 |
220 |
$7K |
| 92587 |
|
166 |
164 |
$5K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
95 |
94 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
51 |
51 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
30 |
30 |
$1K |
| 90461 |
|
43 |
43 |
$907.05 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
13 |
13 |
$833.64 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
17 |
17 |
$653.40 |
| 99174 |
|
80 |
78 |
$386.79 |
| 96127 |
|
114 |
112 |
$382.92 |
| 90686 |
|
32 |
32 |
$100.15 |
| 90658 |
|
40 |
39 |
$61.01 |
| 3008F |
|
187 |
184 |
$0.00 |
| 90647 |
|
26 |
26 |
$0.00 |
| 99173 |
|
107 |
96 |
$0.00 |
| 90670 |
|
40 |
24 |
$0.00 |