| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
746 |
622 |
$56K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,078 |
951 |
$47K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
570 |
462 |
$38K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
592 |
521 |
$38K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
350 |
331 |
$26K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
314 |
298 |
$26K |
| 90670 |
|
463 |
397 |
$7K |
| 96127 |
|
320 |
295 |
$5K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
225 |
180 |
$4K |
| 90686 |
|
412 |
374 |
$3K |
| 90651 |
|
68 |
61 |
$2K |
| 90698 |
|
285 |
243 |
$2K |
| 90734 |
|
75 |
65 |
$2K |
| 83655 |
|
121 |
92 |
$1K |
| 90633 |
|
137 |
117 |
$1K |
| 90647 |
|
146 |
110 |
$921.60 |
| 90723 |
|
85 |
73 |
$531.52 |
| 85018 |
|
163 |
137 |
$366.56 |
| 96160 |
|
22 |
19 |
$308.00 |
| 90680 |
|
33 |
26 |
$198.40 |
| 90744 |
|
26 |
26 |
$166.40 |
| 90700 |
|
22 |
15 |
$140.80 |
| 90681 |
|
12 |
12 |
$76.80 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
26 |
26 |
$0.00 |
| 90461 |
|
13 |
13 |
$0.00 |