| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 96160 |
|
30 |
26 |
$380.00 |
| 99443 |
|
392 |
297 |
$169.57 |
| 99215 |
Prolong outpt/office vis |
481 |
359 |
$25.00 |
| 99401 |
|
17 |
15 |
$0.00 |
| 4035F |
|
37 |
37 |
$0.00 |
| 99411 |
|
115 |
104 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
24 |
18 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
17 |
13 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
897 |
683 |
$0.00 |
| 99402 |
|
168 |
141 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
110 |
102 |
$0.00 |
| 3008F |
|
27 |
25 |
$0.00 |
| 96156 |
|
12 |
12 |
$0.00 |