| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
68 |
68 |
$10K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
197 |
197 |
$6K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
40 |
36 |
$5K |
| 90461 |
|
144 |
144 |
$4K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
22 |
22 |
$4K |
| H1000 |
Prenatal care, at-risk assessment |
44 |
40 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
13 |
13 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
14 |
13 |
$136.92 |
| 90698 |
|
147 |
147 |
$0.00 |
| 90680 |
|
80 |
80 |
$0.00 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
44 |
44 |
$0.00 |
| 90686 |
|
17 |
17 |
$0.00 |
| 97802 |
|
44 |
44 |
$0.00 |
| G0270 |
Medical nutrition therapy; reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition or treatment regimen (including additional hours needed for renal disease), individual, face to face with the patient, each 15 minutes |
44 |
44 |
$0.00 |
| 99173 |
|
33 |
33 |
$0.00 |
| 90670 |
|
96 |
96 |
$0.00 |
| 92552 |
|
38 |
38 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
14 |
14 |
$0.00 |