| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,307 |
1,235 |
$103K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,108 |
1,070 |
$94K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
4,404 |
1,759 |
$47K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
201 |
197 |
$18K |
| 99215 |
Prolong outpt/office vis |
96 |
93 |
$15K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
266 |
254 |
$13K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
632 |
542 |
$6K |
| 90461 |
|
573 |
471 |
$4K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
14 |
12 |
$1K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
124 |
124 |
$198.43 |
| 88720 |
|
14 |
13 |
$56.84 |
| 84030 |
|
16 |
14 |
$53.61 |
| 90677 |
|
12 |
12 |
$0.07 |
| 90670 |
|
279 |
272 |
$0.00 |
| 90685 |
|
48 |
45 |
$0.00 |
| 90633 |
|
13 |
13 |
$0.00 |
| 90723 |
|
38 |
37 |
$0.00 |
| 90647 |
|
48 |
46 |
$0.00 |
| 90680 |
|
103 |
100 |
$0.00 |
| 90686 |
|
244 |
239 |
$0.00 |