| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
416 |
385 |
$38K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
580 |
527 |
$37K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
284 |
265 |
$19K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
112 |
109 |
$8K |
| D0191 |
|
670 |
648 |
$8K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
590 |
570 |
$5K |
| 96127 |
|
753 |
721 |
$2K |
| 99383 |
|
14 |
14 |
$1K |
| 90698 |
|
69 |
67 |
$1K |
| 99174 |
|
166 |
158 |
$682.76 |
| 90671 |
|
38 |
38 |
$614.88 |
| 94760 |
|
284 |
263 |
$529.62 |
| 90677 |
|
16 |
13 |
$442.38 |
| 90670 |
|
13 |
13 |
$259.12 |
| 90688 |
|
15 |
15 |
$241.56 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
204 |
186 |
$61.08 |
| 96160 |
|
154 |
148 |
$39.35 |
| 90461 |
|
108 |
107 |
$0.00 |
| 83655 |
|
12 |
12 |
$0.00 |
| 36416 |
|
17 |
17 |
$0.00 |
| 85018 |
|
12 |
12 |
$0.00 |