| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
214 |
177 |
$17K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
348 |
293 |
$15K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
187 |
182 |
$13K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
69 |
65 |
$7K |
| 99460 |
|
97 |
89 |
$6K |
| 99462 |
|
105 |
62 |
$2K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
30 |
29 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
32 |
29 |
$215.12 |
| 96161 |
|
55 |
52 |
$102.25 |
| 36416 |
|
15 |
14 |
$49.90 |
| 90670 |
|
78 |
68 |
$0.00 |
| 90461 |
|
238 |
201 |
$0.00 |
| 90648 |
|
15 |
12 |
$0.00 |
| 90698 |
|
28 |
23 |
$0.00 |
| 90680 |
|
18 |
14 |
$0.00 |