| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,745 |
1,721 |
$222K |
| G9920 |
Screening performed and negative |
1,166 |
1,166 |
$20K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,099 |
2,090 |
$17K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
238 |
234 |
$11K |
| 90480 |
|
154 |
154 |
$9K |
| 97803 |
|
423 |
411 |
$7K |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
968 |
731 |
$4K |
| 99215 |
Prolong outpt/office vis |
698 |
659 |
$4K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
255 |
255 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,986 |
1,913 |
$3K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,018 |
1,879 |
$2K |
| 99188 |
|
90 |
90 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
769 |
744 |
$2K |
| 0124A |
|
33 |
33 |
$2K |
| 90461 |
|
139 |
139 |
$926.56 |
| 90688 |
|
107 |
107 |
$684.11 |
| 99401 |
|
16 |
16 |
$480.00 |
| 92552 |
|
1,144 |
1,139 |
$387.05 |
| 96127 |
|
826 |
824 |
$131.23 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
310 |
288 |
$85.24 |
| D1206 |
Topical application of fluoride varnish |
310 |
310 |
$18.00 |
| 99173 |
|
903 |
901 |
$2.39 |
| 90473 |
|
108 |
108 |
$0.00 |
| G9919 |
Screening performed and positive and provision of recommendations |
27 |
27 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
13 |
13 |
$0.00 |
| 87070 |
|
68 |
67 |
$0.00 |
| 87110 |
|
66 |
65 |
$0.00 |
| 99000 |
|
163 |
161 |
$0.00 |