| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
280 |
280 |
$16K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
378 |
378 |
$16K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
145 |
145 |
$8K |
| 90461 |
|
203 |
202 |
$8K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
643 |
519 |
$8K |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
356 |
356 |
$7K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
87 |
87 |
$4K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
56 |
56 |
$3K |
| 92587 |
|
118 |
118 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
35 |
35 |
$2K |
| 92551 |
|
118 |
118 |
$1K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
102 |
102 |
$1K |
| 81000 |
|
145 |
145 |
$434.28 |
| 1031F |
|
612 |
610 |
$0.00 |
| 96127 |
|
20 |
20 |
$0.00 |
| 90674 |
|
29 |
29 |
$0.00 |
| 97802 |
|
272 |
272 |
$0.00 |
| 90686 |
|
27 |
27 |
$0.00 |
| 90697 |
|
25 |
25 |
$0.00 |
| 90677 |
|
46 |
46 |
$0.00 |
| 99080 |
|
2,296 |
458 |
$0.00 |
| 99173 |
|
88 |
88 |
$0.00 |
| 99177 |
|
61 |
61 |
$0.00 |
| 90681 |
|
12 |
12 |
$0.00 |
| 90671 |
|
17 |
17 |
$0.00 |
| 90633 |
|
14 |
14 |
$0.00 |