| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
6,404 |
6,008 |
$526K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
7,709 |
7,046 |
$440K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
682 |
676 |
$56K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
531 |
529 |
$49K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
100 |
100 |
$8K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
59 |
58 |
$4K |
| 17110 |
|
46 |
45 |
$3K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
74 |
69 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
187 |
182 |
$2K |
| 92587 |
|
94 |
93 |
$1K |
| 99406 |
|
105 |
103 |
$826.75 |
| 94060 |
|
24 |
24 |
$780.75 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
15 |
15 |
$141.14 |
| 96160 |
|
36 |
36 |
$66.78 |
| 1159F |
|
124 |
122 |
$0.00 |
| 90461 |
|
15 |
15 |
$0.00 |