| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,521 |
1,428 |
$108K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
872 |
789 |
$74K |
| J0585 |
Injection, onabotulinumtoxina, 1 unit |
23 |
12 |
$12K |
| 90686 |
|
543 |
527 |
$11K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
42 |
42 |
$4K |
| 64615 |
|
38 |
36 |
$4K |
| 93000 |
|
300 |
284 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
14 |
13 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
14 |
14 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
117 |
89 |
$909.76 |
| 92551 |
|
58 |
58 |
$673.74 |
| 90656 |
|
27 |
27 |
$572.28 |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
13 |
12 |
$425.20 |
| 90672 |
|
15 |
15 |
$329.40 |
| 36415 |
Collection of venous blood by venipuncture |
64 |
62 |
$195.12 |
| 99173 |
|
37 |
37 |
$106.19 |
| 91307 |
|
15 |
15 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
12 |
12 |
$0.00 |