| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
58 |
58 |
$2K |
| 92551 |
|
177 |
176 |
$568.40 |
| 90658 |
|
20 |
20 |
$180.00 |
| 99173 |
|
49 |
49 |
$174.46 |
| 85999 |
|
44 |
44 |
$132.44 |
| 81000 |
|
166 |
165 |
$126.28 |
| 96156 |
|
265 |
222 |
$46.52 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
31 |
31 |
$0.00 |
| 90700 |
|
12 |
12 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
13 |
13 |
$0.00 |
| 85018 |
|
131 |
130 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
201 |
177 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
58 |
56 |
$0.00 |