| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
212 |
192 |
$16K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
54 |
51 |
$6K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
28 |
28 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
28 |
28 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
13 |
13 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
122 |
122 |
$2K |
| 90461 |
|
70 |
70 |
$1K |
| 96127 |
|
99 |
95 |
$751.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
70 |
70 |
$597.24 |
| 80061 |
Lipid panel |
41 |
41 |
$473.40 |
| 99188 |
|
26 |
26 |
$421.20 |
| 85018 |
|
102 |
102 |
$209.10 |
| 90686 |
|
38 |
38 |
$0.00 |