| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
124 |
118 |
$14K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
93 |
93 |
$10K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
130 |
121 |
$10K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
41 |
41 |
$4K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
181 |
180 |
$2K |
| 99188 |
|
134 |
134 |
$2K |
| 90461 |
|
100 |
100 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
31 |
31 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
128 |
128 |
$1K |
| 96127 |
|
73 |
73 |
$554.58 |
| 85018 |
|
135 |
135 |
$276.75 |
| 99177 |
|
58 |
58 |
$167.58 |
| 80061 |
Lipid panel |
14 |
14 |
$162.54 |
| 83655 |
|
13 |
13 |
$136.37 |
| 90698 |
|
12 |
12 |
$0.00 |
| 90686 |
|
47 |
47 |
$0.00 |
| 90670 |
|
25 |
25 |
$0.00 |
| 90633 |
|
28 |
28 |
$0.00 |