| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,277 |
1,158 |
$46K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
271 |
269 |
$21K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,864 |
816 |
$18K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
111 |
111 |
$9K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
76 |
75 |
$4K |
| 99429 |
|
120 |
120 |
$4K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
43 |
39 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
25 |
25 |
$2K |
| 90461 |
|
382 |
311 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
167 |
124 |
$1K |
| 99000 |
|
39 |
38 |
$280.80 |
| 83655 |
|
12 |
12 |
$122.04 |
| 90686 |
|
269 |
265 |
$0.00 |