| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
58 |
58 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
39 |
39 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
12 |
12 |
$652.20 |
| 92551 |
|
65 |
65 |
$616.10 |
| 85018 |
|
15 |
15 |
$30.75 |
| 90461 |
|
16 |
15 |
$0.00 |
| 92081 |
|
96 |
96 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
27 |
27 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
85 |
47 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
55 |
50 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
19 |
18 |
$0.00 |