| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,308 |
1,249 |
$57K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
759 |
729 |
$50K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
321 |
310 |
$10K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
12 |
12 |
$759.88 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
14 |
12 |
$737.59 |
| 99177 |
|
70 |
69 |
$730.91 |
| 99174 |
|
43 |
41 |
$436.04 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
12 |
12 |
$100.23 |
| 90461 |
|
60 |
55 |
$54.60 |