| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
622 |
487 |
$40K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
440 |
298 |
$33K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
606 |
499 |
$27K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
213 |
181 |
$15K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
474 |
242 |
$8K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
55 |
41 |
$4K |
| 90670 |
|
441 |
376 |
$3K |
| 90686 |
|
375 |
305 |
$2K |
| 90648 |
|
319 |
251 |
$2K |
| 90680 |
|
282 |
240 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
65 |
62 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
21 |
18 |
$2K |
| 54150 |
|
22 |
12 |
$1K |
| 90723 |
|
190 |
164 |
$1K |
| 90633 |
|
180 |
111 |
$1K |
| 83655 |
|
93 |
66 |
$1K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
26 |
25 |
$904.45 |
| 99460 |
|
14 |
14 |
$542.50 |
| 90688 |
|
89 |
88 |
$537.41 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
168 |
155 |
$199.12 |
| 90710 |
|
31 |
28 |
$193.28 |
| 90651 |
|
22 |
17 |
$134.40 |
| 90698 |
|
18 |
13 |
$102.40 |
| 88720 |
|
16 |
13 |
$70.40 |