| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
66 |
65 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
51 |
50 |
$5K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
39 |
39 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
89 |
79 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
236 |
120 |
$2K |
| 90461 |
|
51 |
42 |
$344.36 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
52 |
47 |
$179.00 |
| 96160 |
|
16 |
16 |
$16.82 |
| 90686 |
|
96 |
96 |
$0.05 |
| 90651 |
|
14 |
14 |
$0.01 |
| 99000 |
|
13 |
13 |
$0.00 |