| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
224 |
205 |
$18K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
133 |
124 |
$7K |
| 99215 |
Prolong outpt/office vis |
26 |
25 |
$3K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
13 |
13 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
29 |
29 |
$276.00 |
| 81002 |
|
13 |
13 |
$14.30 |
| 99401 |
|
168 |
168 |
$0.00 |