| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
392 |
353 |
$41K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
259 |
243 |
$18K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
58 |
58 |
$7K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
48 |
48 |
$5K |
| 90461 |
|
82 |
81 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
160 |
159 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
13 |
13 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$1K |
| 97802 |
|
46 |
46 |
$1K |
| 99051 |
|
96 |
91 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
140 |
138 |
$995.40 |
| 97803 |
|
44 |
44 |
$612.04 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
15 |
15 |
$177.15 |
| 81002 |
|
34 |
34 |
$92.14 |
| 94760 |
|
13 |
13 |
$0.00 |
| 90658 |
|
18 |
18 |
$0.00 |
| 90670 |
|
12 |
12 |
$0.00 |
| 90715 |
|
12 |
12 |
$0.00 |
| 90649 |
|
29 |
29 |
$0.00 |
| 90633 |
|
12 |
12 |
$0.00 |