| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
45 |
44 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
28 |
25 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
50 |
48 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
26 |
25 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
15 |
14 |
$899.91 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$700.92 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
52 |
47 |
$482.57 |
| 92551 |
|
36 |
36 |
$151.74 |
| 99173 |
|
36 |
36 |
$28.10 |
| 90461 |
|
19 |
19 |
$0.00 |
| 90670 |
|
16 |
16 |
$0.00 |
| 90647 |
|
12 |
12 |
$0.00 |