| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
3,513 |
3,492 |
$131K |
| 90791 |
Psychiatric diagnostic evaluation |
1,604 |
1,603 |
$119K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
2,316 |
2,308 |
$94K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,052 |
2,007 |
$75K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
7,923 |
5,904 |
$67K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
15,668 |
13,959 |
$44K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
427 |
212 |
$24K |
| 92552 |
|
438 |
437 |
$4K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
98 |
93 |
$3K |
| 99173 |
|
887 |
885 |
$3K |
| 90685 |
|
180 |
157 |
$2K |
| 90480 |
|
41 |
41 |
$2K |
| 0124A |
|
23 |
23 |
$920.00 |
| 97802 |
|
724 |
722 |
$784.95 |
| 0073A |
|
16 |
16 |
$640.00 |
| 90670 |
|
120 |
120 |
$621.00 |
| 0053A |
|
13 |
13 |
$520.00 |
| 90686 |
|
1,290 |
1,290 |
$399.33 |
| 90698 |
|
75 |
75 |
$225.00 |
| 90680 |
|
12 |
12 |
$108.00 |
| 90461 |
|
553 |
534 |
$48.48 |
| 90633 |
|
73 |
73 |
$0.00 |
| 90734 |
|
149 |
149 |
$0.00 |
| 91320 |
|
14 |
14 |
$0.00 |
| 90621 |
|
36 |
36 |
$0.00 |
| 90710 |
|
32 |
32 |
$0.00 |
| 90715 |
|
13 |
13 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
28 |
28 |
$0.00 |
| 90651 |
|
477 |
476 |
$0.00 |
| 99000 |
|
79 |
79 |
$0.00 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
91 |
91 |
$0.00 |
| 99441 |
|
73 |
71 |
$0.00 |