| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
582 |
494 |
$15K |
| 96156 |
|
239 |
212 |
$12K |
| G9920 |
Screening performed and negative |
139 |
122 |
$3K |
| 92551 |
|
191 |
179 |
$3K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
45 |
38 |
$903.10 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
15 |
15 |
$848.55 |
| 90688 |
|
64 |
63 |
$668.00 |
| 99188 |
|
50 |
50 |
$650.16 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
37 |
37 |
$618.16 |
| 90672 |
|
20 |
19 |
$234.00 |
| 96127 |
|
33 |
25 |
$68.20 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
361 |
347 |
$0.00 |
| 99173 |
|
162 |
162 |
$0.00 |
| 90461 |
|
30 |
30 |
$0.00 |