| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
389 |
335 |
$7K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
216 |
216 |
$5K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
110 |
110 |
$4K |
| 92587 |
|
115 |
114 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
28 |
28 |
$924.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
25 |
25 |
$820.05 |
| 90461 |
|
38 |
38 |
$433.50 |
| 90686 |
|
13 |
13 |
$242.58 |
| 97802 |
|
83 |
83 |
$0.00 |
| 99174 |
|
43 |
43 |
$0.00 |
| 99000 |
|
24 |
24 |
$0.00 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
83 |
83 |
$0.00 |
| 3008F |
|
83 |
83 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
25 |
25 |
$0.00 |
| 99072 |
|
76 |
71 |
$0.00 |