| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99460 |
|
111 |
109 |
$5K |
| 99462 |
|
165 |
99 |
$4K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
106 |
101 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
93 |
93 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
42 |
42 |
$2K |
| 92551 |
|
270 |
270 |
$1K |
| 90688 |
|
63 |
62 |
$444.85 |
| 83655 |
|
57 |
57 |
$410.28 |
| 85018 |
|
264 |
264 |
$356.70 |
| 86580 |
|
155 |
154 |
$352.98 |
| 97802 |
|
107 |
106 |
$327.81 |
| 90670 |
|
45 |
45 |
$252.00 |
| 82465 |
|
113 |
113 |
$200.20 |
| 82947 |
|
122 |
121 |
$192.93 |
| 90633 |
|
28 |
28 |
$81.00 |
| 90700 |
|
12 |
12 |
$72.00 |
| 90685 |
|
12 |
12 |
$63.00 |
| 92081 |
|
204 |
204 |
$34.08 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
927 |
811 |
$12.00 |
| 90686 |
|
40 |
40 |
$9.00 |
| 85032 |
|
80 |
80 |
$4.63 |
| 99173 |
|
51 |
51 |
$0.00 |
| 99401 |
|
107 |
106 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
90 |
90 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
107 |
106 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
106 |
105 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
73 |
73 |
$0.00 |
| 90657 |
|
24 |
24 |
$0.00 |