| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
875 |
655 |
$46K |
| 99199 |
Unlisted special service, procedure or report |
2,555 |
2,547 |
$42K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
85 |
71 |
$8K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
28 |
24 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
77 |
59 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
41 |
27 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
290 |
237 |
$2K |
| 81002 |
|
885 |
614 |
$1K |
| 81003 |
|
1,576 |
793 |
$516.13 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
34 |
25 |
$392.59 |
| 90686 |
|
19 |
12 |
$232.44 |
| 81001 |
|
147 |
119 |
$34.45 |
| 0503F |
|
12 |
12 |
$0.00 |
| 0502F |
|
6,146 |
3,927 |
$0.00 |