| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,609 |
1,411 |
$56K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
405 |
395 |
$38K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
89 |
85 |
$8K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
393 |
390 |
$7K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
75 |
75 |
$7K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
36 |
36 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
13 |
13 |
$1K |
| 90686 |
|
202 |
199 |
$391.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
61 |
51 |
$252.34 |
| 92551 |
|
218 |
210 |
$192.00 |
| 99173 |
|
217 |
209 |
$132.00 |
| 90656 |
|
45 |
45 |
$0.00 |