| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,016 |
1,015 |
$52K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,242 |
1,241 |
$52K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,127 |
1,120 |
$42K |
| 92552 |
|
1,757 |
1,754 |
$27K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,035 |
1,263 |
$20K |
| 90686 |
|
1,907 |
1,903 |
$14K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
8,759 |
8,095 |
$13K |
| 92551 |
|
949 |
949 |
$9K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,985 |
3,662 |
$9K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
73 |
70 |
$4K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
84 |
83 |
$3K |
| 90656 |
|
203 |
201 |
$2K |
| 90670 |
|
181 |
180 |
$2K |
| 90698 |
|
154 |
153 |
$1K |
| 99173 |
|
358 |
356 |
$897.24 |
| 90620 |
|
64 |
64 |
$411.00 |
| 90633 |
|
43 |
36 |
$234.00 |
| 90716 |
|
29 |
27 |
$207.00 |
| 90707 |
|
29 |
27 |
$207.00 |
| 90651 |
|
28 |
27 |
$144.00 |
| 90680 |
|
12 |
12 |
$108.00 |
| 90619 |
|
13 |
13 |
$108.00 |
| 96127 |
|
56 |
56 |
$0.00 |
| 90688 |
|
70 |
69 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,280 |
1,177 |
$0.00 |
| 92081 |
|
867 |
867 |
$0.00 |
| 99442 |
|
77 |
75 |
$0.00 |