| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
886 |
857 |
$152K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
43 |
42 |
$7K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
17 |
17 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
14 |
14 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
13 |
13 |
$2K |
| 99215 |
Prolong outpt/office vis |
13 |
13 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
283 |
281 |
$239.59 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
13 |
13 |
$0.00 |
| 96127 |
|
12 |
12 |
$0.00 |
| 90723 |
|
12 |
12 |
$0.00 |
| 90461 |
|
61 |
61 |
$0.00 |
| 90670 |
|
29 |
29 |
$0.00 |
| 99173 |
|
25 |
25 |
$0.00 |