| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
14 |
13 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$974.64 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
12 |
12 |
$703.84 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
47 |
44 |
$378.84 |
| 90670 |
|
25 |
25 |
$288.75 |
| 99174 |
|
12 |
12 |
$62.64 |
| 36416 |
|
13 |
12 |
$8.80 |