| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,098 |
1,014 |
$65K |
| 99215 |
Prolong outpt/office vis |
446 |
408 |
$36K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
121 |
87 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
303 |
291 |
$2K |
| 99350 |
Prolong home eval add 15m |
54 |
48 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
15 |
13 |
$754.25 |
| 90658 |
|
13 |
12 |
$0.00 |