| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
347 |
329 |
$26K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
434 |
427 |
$16K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
150 |
146 |
$16K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
60 |
57 |
$5K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
25 |
25 |
$2K |
| 99383 |
|
14 |
14 |
$1K |
| 96127 |
|
115 |
113 |
$450.65 |
| 99177 |
|
130 |
130 |
$354.14 |
| 96160 |
|
382 |
380 |
$341.37 |
| 87807 |
|
12 |
12 |
$133.03 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
14 |
14 |
$91.60 |
| 92558 |
|
14 |
14 |
$35.06 |
| 99000 |
|
32 |
27 |
$14.76 |
| 90671 |
|
12 |
12 |
$0.00 |
| 90698 |
|
12 |
12 |
$0.00 |