| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,458 |
1,144 |
$107K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,161 |
922 |
$94K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,478 |
1,375 |
$79K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
2,691 |
2,321 |
$52K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
327 |
250 |
$27K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
191 |
183 |
$17K |
| 90670 |
|
659 |
576 |
$15K |
| 90680 |
|
578 |
498 |
$9K |
| 90677 |
|
274 |
222 |
$9K |
| 90697 |
|
446 |
398 |
$8K |
| 90686 |
|
498 |
442 |
$7K |
| 90633 |
|
417 |
325 |
$6K |
| 90698 |
|
279 |
220 |
$4K |
| 90744 |
|
189 |
142 |
$2K |
| 90656 |
|
126 |
114 |
$2K |
| 96127 |
|
116 |
106 |
$2K |
| 99460 |
|
27 |
27 |
$2K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
24 |
24 |
$1K |
| 90710 |
|
66 |
40 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
13 |
13 |
$1K |
| 99174 |
|
129 |
100 |
$974.47 |
| 99215 |
Prolong outpt/office vis |
13 |
13 |
$917.93 |
| 90707 |
|
28 |
28 |
$478.88 |
| 90716 |
|
28 |
28 |
$478.88 |
| 90696 |
|
19 |
12 |
$156.16 |
| 90651 |
|
13 |
12 |
$104.32 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,615 |
1,315 |
$0.00 |
| 90461 |
|
1,057 |
830 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
29 |
29 |
$0.00 |