| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
675 |
609 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
112 |
110 |
$280.89 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
399 |
388 |
$56.91 |
| 90688 |
|
28 |
28 |
$0.00 |
| S9999 |
Sales tax |
130 |
125 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
24 |
24 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
23 |
23 |
$0.00 |