| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,265 |
1,073 |
$94K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
947 |
839 |
$73K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
561 |
484 |
$41K |
| 90686 |
|
1,494 |
1,360 |
$16K |
| 87428 |
|
180 |
163 |
$12K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
159 |
137 |
$12K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
270 |
247 |
$11K |
| 90670 |
|
821 |
753 |
$8K |
| 90723 |
|
606 |
545 |
$6K |
| 90647 |
|
442 |
404 |
$5K |
| 90716 |
|
120 |
113 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,169 |
955 |
$1K |
| 90656 |
|
100 |
67 |
$973.35 |
| 90707 |
|
86 |
81 |
$944.98 |
| 90633 |
|
92 |
82 |
$916.38 |
| 90648 |
|
42 |
37 |
$571.65 |
| 90734 |
|
40 |
36 |
$397.82 |
| 90681 |
|
41 |
38 |
$363.28 |
| 90677 |
|
19 |
12 |
$157.68 |
| 90685 |
|
19 |
16 |
$133.84 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,306 |
1,148 |
$121.22 |
| 90651 |
|
13 |
12 |
$114.72 |
| 96127 |
|
105 |
63 |
$33.99 |
| 99173 |
|
54 |
49 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
705 |
638 |
$0.00 |
| 96161 |
|
18 |
14 |
$0.00 |
| 92551 |
|
83 |
76 |
$0.00 |