| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
253 |
238 |
$15K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
372 |
344 |
$14K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
35 |
30 |
$2K |
| 90686 |
|
109 |
103 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$798.24 |
| 99238 |
Hospital discharge day management, 30 minutes or less |
24 |
23 |
$711.60 |
| 90656 |
|
38 |
35 |
$643.91 |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
23 |
16 |
$480.60 |
| 99460 |
|
14 |
13 |
$468.88 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
17 |
15 |
$273.25 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
37 |
24 |
$0.00 |