| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
598 |
591 |
$28K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
634 |
625 |
$24K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
448 |
439 |
$14K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
302 |
300 |
$9K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
260 |
249 |
$9K |
| 90686 |
|
668 |
664 |
$9K |
| 99384 |
|
115 |
115 |
$8K |
| 99383 |
|
126 |
126 |
$8K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,627 |
4,376 |
$7K |
| 90688 |
|
650 |
648 |
$6K |
| 90651 |
|
323 |
317 |
$4K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
125 |
125 |
$4K |
| 90698 |
|
150 |
143 |
$3K |
| 99382 |
|
49 |
49 |
$2K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
2,121 |
1,983 |
$2K |
| 90670 |
|
201 |
192 |
$2K |
| 90656 |
|
90 |
89 |
$875.92 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,696 |
3,446 |
$761.06 |
| 90734 |
|
46 |
46 |
$570.48 |
| 90620 |
|
63 |
63 |
$505.92 |
| 90685 |
|
32 |
32 |
$317.44 |
| 90674 |
|
31 |
31 |
$277.76 |
| 90680 |
|
26 |
26 |
$248.00 |
| 90715 |
|
13 |
13 |
$174.46 |
| 90661 |
|
12 |
12 |
$154.66 |
| 90710 |
|
14 |
14 |
$138.88 |
| 90649 |
|
14 |
14 |
$138.88 |
| 90744 |
|
12 |
12 |
$119.04 |
| 90633 |
|
17 |
17 |
$99.20 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
369 |
350 |
$19.96 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
110 |
107 |
$18.37 |
| 86580 |
|
12 |
12 |
$7.40 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
48 |
48 |
$0.00 |
| 91300 |
|
43 |
43 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
397 |
390 |
$0.00 |
| 0002A |
|
43 |
43 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
226 |
220 |
$0.00 |
| 99386 |
|
54 |
52 |
$0.00 |
| 0001A |
|
15 |
15 |
$0.00 |