| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
518 |
518 |
$17K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
425 |
425 |
$14K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
377 |
377 |
$12K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
226 |
219 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
44 |
43 |
$1K |
| 90686 |
|
32 |
32 |
$538.24 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
25 |
25 |
$530.34 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
481 |
472 |
$413.80 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
12 |
12 |
$396.00 |
| 36415 |
Collection of venous blood by venipuncture |
53 |
52 |
$49.60 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
61 |
61 |
$5.93 |
| 36406 |
|
26 |
26 |
$0.00 |