| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
78 |
75 |
$7K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
32 |
27 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
24 |
12 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
13 |
13 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
15 |
12 |
$784.70 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
30 |
30 |
$780.00 |
| 99173 |
|
51 |
39 |
$183.25 |
| 90723 |
|
13 |
13 |
$130.00 |
| 90670 |
|
13 |
13 |
$130.00 |
| 90648 |
|
13 |
13 |
$130.00 |
| 90680 |
|
12 |
12 |
$120.00 |
| 90686 |
|
25 |
25 |
$0.00 |
| G9919 |
Screening performed and positive and provision of recommendations |
47 |
47 |
$0.00 |
| G9920 |
Screening performed and negative |
13 |
13 |
$0.00 |