| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
976 |
912 |
$74K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
725 |
714 |
$59K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,555 |
1,334 |
$48K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
4,871 |
1,957 |
$47K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
420 |
415 |
$38K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
492 |
453 |
$22K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
216 |
216 |
$18K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
774 |
554 |
$6K |
| 90461 |
|
809 |
633 |
$5K |
| 83655 |
|
160 |
159 |
$1K |
| 99381 |
|
13 |
13 |
$1K |
| 99429 |
|
30 |
29 |
$944.92 |
| 96160 |
|
124 |
121 |
$303.35 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
14 |
14 |
$191.51 |
| 90658 |
|
605 |
601 |
$0.02 |
| 90633 |
|
112 |
112 |
$0.00 |
| 90648 |
|
117 |
117 |
$0.00 |
| 90670 |
|
495 |
492 |
$0.00 |
| 90671 |
|
89 |
87 |
$0.00 |
| 90649 |
|
13 |
13 |
$0.00 |
| 90734 |
|
51 |
51 |
$0.00 |
| 90715 |
|
14 |
14 |
$0.00 |
| 90651 |
|
17 |
17 |
$0.00 |
| 90680 |
|
297 |
296 |
$0.00 |
| 90723 |
|
110 |
110 |
$0.00 |
| 90698 |
|
91 |
90 |
$0.00 |
| 90697 |
|
13 |
13 |
$0.00 |