| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
525 |
451 |
$17K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
108 |
107 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
15 |
15 |
$676.76 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
35 |
24 |
$535.50 |
| 85018 |
|
381 |
344 |
$399.56 |
| 81000 |
|
104 |
98 |
$161.88 |
| 92552 |
|
12 |
12 |
$110.40 |
| 90686 |
|
334 |
302 |
$49.60 |
| 90670 |
|
83 |
54 |
$9.92 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,131 |
1,029 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
118 |
118 |
$0.00 |
| 90461 |
|
36 |
36 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
27 |
27 |
$0.00 |
| 90633 |
|
14 |
12 |
$0.00 |
| 90698 |
|
79 |
52 |
$0.00 |
| 92587 |
|
59 |
59 |
$0.00 |