| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
576 |
549 |
$54K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,251 |
1,290 |
$48K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
491 |
489 |
$46K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
365 |
359 |
$36K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
158 |
154 |
$17K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
38 |
38 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
230 |
154 |
$2K |
| 92551 |
|
322 |
311 |
$2K |
| 90461 |
|
275 |
224 |
$1K |
| 96160 |
|
165 |
161 |
$444.24 |
| 90677 |
|
180 |
180 |
$0.69 |
| 90697 |
|
42 |
42 |
$0.12 |
| 90686 |
|
387 |
385 |
$0.09 |
| 90651 |
|
41 |
41 |
$0.02 |
| 90680 |
|
68 |
68 |
$0.00 |
| 90723 |
|
91 |
91 |
$0.00 |
| 90716 |
|
13 |
13 |
$0.00 |
| 90698 |
|
18 |
18 |
$0.00 |
| 90633 |
|
117 |
116 |
$0.00 |
| 90670 |
|
255 |
255 |
$0.00 |
| 90648 |
|
156 |
156 |
$0.00 |
| 99173 |
|
369 |
364 |
$0.00 |
| 90681 |
|
60 |
60 |
$0.00 |
| 90707 |
|
13 |
13 |
$0.00 |
| 90734 |
|
14 |
14 |
$0.00 |