| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
159 |
132 |
$10K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
156 |
132 |
$8K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
111 |
102 |
$8K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
46 |
40 |
$3K |
| 90677 |
|
97 |
91 |
$2K |
| 99383 |
|
23 |
19 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
29 |
25 |
$2K |
| 90656 |
|
80 |
78 |
$1K |
| 96127 |
|
84 |
72 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
13 |
13 |
$1K |
| 90723 |
|
58 |
56 |
$969.18 |
| 90680 |
|
56 |
54 |
$935.76 |
| 90647 |
|
39 |
39 |
$651.69 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
17 |
15 |
$321.58 |