| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
86 |
85 |
$5K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
41 |
41 |
$4K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
40 |
37 |
$2K |
| 90686 |
|
62 |
62 |
$891.03 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
34 |
34 |
$282.57 |
| 90633 |
|
12 |
12 |
$120.00 |
| 99188 |
|
22 |
22 |
$120.00 |
| 99173 |
|
61 |
60 |
$90.64 |