| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,182 |
818 |
$23K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
176 |
143 |
$11K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
17 |
15 |
$1K |
| 87428 |
|
15 |
15 |
$955.37 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$951.36 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
15 |
12 |
$751.36 |
| 96160 |
|
297 |
218 |
$322.26 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
15 |
15 |
$105.82 |