| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,420 |
1,218 |
$95K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
595 |
555 |
$14K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
384 |
359 |
$14K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
154 |
144 |
$13K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
16 |
16 |
$1K |
| 90461 |
|
15 |
15 |
$222.23 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
69 |
69 |
$165.75 |
| 99173 |
|
57 |
57 |
$105.48 |
| 90686 |
|
12 |
12 |
$0.00 |