| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
178 |
177 |
$14K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
389 |
349 |
$14K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
845 |
402 |
$7K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
40 |
39 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
31 |
31 |
$2K |
| 90461 |
|
185 |
163 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
68 |
47 |
$553.52 |
| 92552 |
|
14 |
14 |
$353.64 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
17 |
15 |
$222.24 |
| 90670 |
|
44 |
42 |
$0.00 |
| 90633 |
|
12 |
12 |
$0.00 |
| 99173 |
|
15 |
15 |
$0.00 |
| 90686 |
|
181 |
181 |
$0.00 |