| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
295 |
252 |
$19K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
221 |
212 |
$19K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
355 |
303 |
$16K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
40 |
40 |
$3K |
| 99215 |
Prolong outpt/office vis |
28 |
28 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
15 |
15 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
50 |
46 |
$868.23 |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
15 |
15 |
$641.20 |
| 90677 |
|
14 |
13 |
$217.23 |
| 90647 |
|
13 |
12 |
$217.23 |