| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,751 |
1,620 |
$147K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
7,047 |
2,759 |
$96K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,043 |
1,021 |
$88K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
300 |
295 |
$25K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
218 |
208 |
$16K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
273 |
263 |
$13K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
897 |
655 |
$8K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
63 |
63 |
$6K |
| 90461 |
|
804 |
652 |
$5K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
12 |
12 |
$1K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
79 |
70 |
$263.62 |
| 96160 |
|
28 |
28 |
$68.11 |
| 90677 |
|
316 |
316 |
$1.78 |
| 90686 |
|
610 |
608 |
$0.55 |
| 90697 |
|
136 |
135 |
$0.45 |
| 90670 |
|
684 |
678 |
$0.02 |
| 90680 |
|
312 |
308 |
$0.01 |
| 90723 |
|
141 |
141 |
$0.00 |
| 90656 |
|
14 |
14 |
$0.00 |
| 90651 |
|
12 |
12 |
$0.00 |
| 90648 |
|
302 |
301 |
$0.00 |
| 90633 |
|
187 |
187 |
$0.00 |
| 90734 |
|
16 |
16 |
$0.00 |
| 90681 |
|
29 |
29 |
$0.00 |
| 90710 |
|
65 |
64 |
$0.00 |