| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
398 |
397 |
$16K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
335 |
335 |
$16K |
| 92551 |
|
1,460 |
1,458 |
$14K |
| 92081 |
|
397 |
395 |
$13K |
| 90686 |
|
921 |
913 |
$8K |
| 92552 |
|
194 |
190 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
55 |
54 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
38 |
38 |
$1K |
| 0002A |
|
18 |
18 |
$720.00 |
| 0001A |
|
18 |
18 |
$720.00 |
| 90651 |
|
97 |
96 |
$694.64 |
| 86580 |
|
205 |
191 |
$577.20 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
972 |
871 |
$419.52 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
992 |
926 |
$410.00 |
| 90734 |
|
25 |
25 |
$168.64 |
| 90620 |
|
12 |
12 |
$89.28 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
155 |
147 |
$0.00 |
| G9920 |
Screening performed and negative |
417 |
417 |
$0.00 |
| 99173 |
|
12 |
12 |
$0.00 |