| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
528 |
459 |
$48K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
359 |
343 |
$35K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,064 |
1,618 |
$18K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
157 |
148 |
$14K |
| 90461 |
|
882 |
786 |
$9K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
681 |
641 |
$8K |
| 90686 |
|
466 |
403 |
$7K |
| 90677 |
|
143 |
139 |
$3K |
| 90698 |
|
149 |
137 |
$3K |
| 90670 |
|
101 |
88 |
$2K |
| 0071A |
|
80 |
73 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
625 |
576 |
$1K |
| 90680 |
|
72 |
65 |
$1K |
| 99173 |
|
389 |
347 |
$903.20 |
| 90656 |
|
37 |
37 |
$666.86 |
| 90744 |
|
38 |
26 |
$458.88 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
289 |
271 |
$404.71 |
| 90633 |
|
14 |
14 |
$253.80 |
| 96127 |
|
20 |
15 |
$139.09 |
| 96161 |
|
40 |
30 |
$99.10 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
35 |
30 |
$88.50 |
| 87430 |
|
14 |
12 |
$84.72 |
| 96160 |
|
17 |
15 |
$41.76 |
| 91307 |
|
59 |
52 |
$0.00 |
| 99441 |
|
26 |
23 |
$0.00 |