| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
6,158 |
5,288 |
$393K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,424 |
2,109 |
$112K |
| 99215 |
Prolong outpt/office vis |
687 |
611 |
$29K |
| 90686 |
|
381 |
285 |
$7K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
44 |
42 |
$4K |
| 99233 |
Prolong inpt eval add15 m |
83 |
24 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
158 |
119 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
20 |
17 |
$1K |
| 0124A |
|
16 |
12 |
$668.80 |
| 0004A |
|
16 |
13 |
$622.82 |
| 90715 |
|
20 |
12 |
$603.58 |
| 90656 |
|
21 |
14 |
$443.19 |
| 96127 |
|
27 |
24 |
$367.75 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
94 |
78 |
$291.24 |
| 99000 |
|
12 |
12 |
$281.52 |