| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
677 |
258 |
$674.56 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
137 |
70 |
$163.82 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
111 |
39 |
$112.38 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
660 |
280 |
$30.00 |
| 92568 |
|
169 |
52 |
$11.46 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
223 |
90 |
$10.00 |
| 96127 |
|
14 |
13 |
$0.00 |
| 99173 |
|
549 |
238 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
79 |
47 |
$0.00 |
| 90461 |
|
78 |
27 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
91 |
42 |
$0.00 |