| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
777 |
710 |
$67K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,182 |
996 |
$62K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
253 |
249 |
$27K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,072 |
1,034 |
$17K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
138 |
122 |
$9K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
575 |
552 |
$3K |
| 99188 |
|
103 |
103 |
$900.64 |
| 92587 |
|
16 |
13 |
$149.31 |
| 85018 |
|
66 |
64 |
$79.80 |
| 85014 |
|
14 |
12 |
$18.62 |
| 90461 |
|
55 |
54 |
$0.00 |
| 99177 |
|
100 |
91 |
$0.00 |
| 90670 |
|
50 |
50 |
$0.00 |
| 90698 |
|
27 |
25 |
$0.00 |
| 36416 |
|
33 |
31 |
$0.00 |
| 90680 |
|
14 |
12 |
$0.00 |