| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,203 |
1,152 |
$44K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
237 |
235 |
$18K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
210 |
208 |
$17K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
225 |
213 |
$12K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
747 |
270 |
$7K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
962 |
884 |
$5K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
47 |
47 |
$4K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
35 |
33 |
$3K |
| 92552 |
|
99 |
94 |
$2K |
| 90461 |
|
85 |
70 |
$346.94 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
30 |
29 |
$305.06 |
| 99000 |
|
14 |
14 |
$114.50 |
| 99072 |
|
624 |
589 |
$8.71 |
| 97803 |
|
326 |
321 |
$2.28 |
| 90686 |
|
76 |
44 |
$0.00 |
| 99173 |
|
126 |
110 |
$0.00 |