| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,026 |
2,658 |
$190K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,645 |
2,400 |
$107K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,795 |
2,758 |
$63K |
| 92587 |
|
1,205 |
1,166 |
$25K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,208 |
1,197 |
$21K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
261 |
259 |
$15K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
268 |
268 |
$15K |
| 90686 |
|
753 |
747 |
$9K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
91 |
86 |
$5K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
75 |
73 |
$4K |
| 0071A |
|
85 |
85 |
$3K |
| 90461 |
|
260 |
260 |
$3K |
| 0072A |
|
79 |
78 |
$3K |
| 99401 |
|
291 |
288 |
$1K |
| 0003A |
|
14 |
14 |
$520.00 |
| 99173 |
|
900 |
854 |
$389.03 |
| 90656 |
|
31 |
31 |
$205.65 |
| 96127 |
|
78 |
76 |
$182.19 |
| 97802 |
|
58 |
58 |
$62.13 |
| 92558 |
|
15 |
15 |
$59.60 |
| 91307 |
|
168 |
150 |
$0.00 |
| 91308 |
|
33 |
30 |
$0.00 |
| 83655 |
|
19 |
19 |
$0.00 |
| 91300 |
|
27 |
27 |
$0.00 |