| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,072 |
1,726 |
$175K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,779 |
2,453 |
$161K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
54 |
49 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
45 |
42 |
$5K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
247 |
236 |
$3K |
| 99309 |
Subsequent nursing facility care, per day, low to moderate complexity |
190 |
131 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
12 |
12 |
$319.20 |
| 81003 |
|
84 |
53 |
$162.41 |
| 90686 |
|
12 |
12 |
$117.69 |