| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
111 |
103 |
$7K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
55 |
55 |
$5K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
120 |
117 |
$4K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
26 |
26 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
12 |
12 |
$991.00 |
| 90670 |
|
88 |
72 |
$791.00 |
| 90686 |
|
82 |
61 |
$671.00 |
| 90647 |
|
67 |
53 |
$582.00 |
| 90723 |
|
46 |
32 |
$352.00 |
| 99173 |
|
50 |
50 |
$245.20 |
| 90681 |
|
12 |
12 |
$132.00 |
| 96161 |
|
29 |
29 |
$111.07 |
| 92551 |
|
49 |
49 |
$78.05 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
15 |
15 |
$7.69 |