| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
206 |
187 |
$16K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
242 |
229 |
$13K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
354 |
353 |
$6K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
27 |
26 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
24 |
24 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
131 |
129 |
$1K |
| 85018 |
|
27 |
27 |
$58.86 |
| 90686 |
|
102 |
102 |
$0.00 |