| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
937 |
679 |
$68K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,418 |
1,214 |
$66K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
760 |
561 |
$12K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
97 |
76 |
$8K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
15 |
15 |
$1K |
| 90651 |
|
19 |
18 |
$941.08 |
| 90649 |
|
16 |
15 |
$102.40 |
| 90658 |
|
13 |
13 |
$83.20 |