| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,556 |
1,245 |
$114K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
605 |
525 |
$28K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
295 |
232 |
$22K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
96 |
77 |
$7K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
396 |
318 |
$7K |
| 90686 |
|
483 |
420 |
$4K |
| 99173 |
|
514 |
442 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
33 |
29 |
$3K |
| 90670 |
|
20 |
12 |
$121.60 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
378 |
292 |
$0.00 |