| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
711 |
706 |
$35K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
256 |
256 |
$27K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
203 |
202 |
$20K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
191 |
190 |
$20K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
265 |
262 |
$19K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
126 |
123 |
$13K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
224 |
224 |
$10K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
69 |
69 |
$8K |
| 99429 |
|
136 |
100 |
$3K |
| 96127 |
|
243 |
241 |
$1K |
| 96161 |
|
227 |
226 |
$899.05 |
| 96160 |
|
183 |
181 |
$718.79 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
28 |
28 |
$406.70 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
65 |
65 |
$300.00 |
| 90647 |
|
24 |
24 |
$0.00 |
| 90723 |
|
12 |
12 |
$0.00 |
| 90619 |
|
14 |
14 |
$0.00 |
| 90697 |
|
32 |
32 |
$0.00 |
| 90633 |
|
12 |
12 |
$0.00 |
| 90670 |
|
119 |
119 |
$0.00 |