| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
817 |
775 |
$74K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,958 |
1,614 |
$67K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
474 |
470 |
$45K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
378 |
371 |
$38K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
230 |
227 |
$25K |
| 99384 |
|
131 |
130 |
$13K |
| 99383 |
|
117 |
116 |
$10K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
296 |
228 |
$3K |
| 99382 |
|
13 |
13 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
13 |
13 |
$569.91 |
| 96160 |
|
167 |
167 |
$433.87 |
| 90461 |
|
24 |
24 |
$184.70 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
14 |
12 |
$45.00 |
| 90677 |
|
265 |
264 |
$1.55 |
| 90686 |
|
294 |
290 |
$0.60 |
| 90697 |
|
41 |
41 |
$0.18 |
| 90651 |
|
19 |
19 |
$0.02 |
| 90620 |
|
13 |
13 |
$0.01 |
| 90648 |
|
195 |
194 |
$0.00 |
| 90681 |
|
120 |
120 |
$0.00 |
| 90734 |
|
73 |
70 |
$0.00 |
| 90633 |
|
59 |
58 |
$0.00 |
| 90670 |
|
175 |
175 |
$0.00 |
| 99173 |
|
13 |
13 |
$0.00 |
| 90715 |
|
12 |
12 |
$0.00 |
| 90710 |
|
28 |
27 |
$0.00 |
| 90723 |
|
131 |
131 |
$0.00 |
| 90656 |
|
27 |
27 |
$0.00 |
| 90680 |
|
28 |
28 |
$0.00 |