| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
932 |
726 |
$67K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
93 |
65 |
$7K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
80 |
52 |
$6K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
102 |
91 |
$5K |
| 90686 |
|
388 |
322 |
$4K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
13 |
12 |
$988.61 |
| 81003 |
|
372 |
281 |
$816.43 |
| 90656 |
|
47 |
45 |
$797.37 |
| 85018 |
|
333 |
279 |
$778.31 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
21 |
12 |
$343.23 |
| 90670 |
|
12 |
12 |
$204.52 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
395 |
293 |
$0.00 |
| 90461 |
|
18 |
18 |
$0.00 |