| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
291 |
270 |
$10K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
160 |
151 |
$8K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
80 |
78 |
$6K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
698 |
338 |
$5K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
31 |
31 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
26 |
26 |
$2K |
| 90461 |
|
152 |
127 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
64 |
42 |
$520.96 |
| 90670 |
|
13 |
13 |
$0.00 |
| 90686 |
|
158 |
156 |
$0.00 |