| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
66 |
66 |
$6K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
179 |
176 |
$6K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
44 |
44 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
28 |
28 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
17 |
17 |
$1K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
12 |
12 |
$375.30 |
| 90686 |
|
34 |
34 |
$374.00 |
| 90670 |
|
14 |
13 |
$143.00 |
| 92551 |
|
120 |
120 |
$55.67 |
| 99173 |
|
116 |
116 |
$24.00 |
| 96161 |
|
12 |
12 |
$19.15 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
12 |
12 |
$0.00 |