| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
163 |
141 |
$22K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
186 |
172 |
$10K |
| 99383 |
|
33 |
25 |
$4K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
36 |
29 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
187 |
159 |
$3K |
| 92552 |
|
75 |
69 |
$3K |
| 92587 |
|
123 |
112 |
$3K |
| 90461 |
|
74 |
66 |
$3K |
| 99384 |
|
24 |
18 |
$3K |
| 99382 |
|
13 |
13 |
$2K |
| 99173 |
|
141 |
117 |
$1K |
| 99177 |
|
51 |
40 |
$600.00 |
| 96127 |
|
37 |
27 |
$145.04 |
| 90633 |
|
15 |
12 |
$0.00 |
| 99080 |
|
12 |
12 |
$0.00 |
| 92551 |
|
16 |
12 |
$0.00 |