| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
3,736 |
3,688 |
$99K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
3,451 |
3,446 |
$77K |
| G9920 |
Screening performed and negative |
6,550 |
6,524 |
$76K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,065 |
2,036 |
$58K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
2,565 |
2,559 |
$54K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
10,533 |
10,099 |
$34K |
| 92551 |
|
7,087 |
7,009 |
$26K |
| 90686 |
|
4,322 |
4,273 |
$20K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,016 |
1,193 |
$12K |
| 92552 |
|
1,218 |
1,217 |
$11K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
213 |
202 |
$10K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,108 |
1,034 |
$4K |
| 99173 |
|
1,248 |
1,246 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
409 |
406 |
$3K |
| 90698 |
|
294 |
291 |
$2K |
| 90670 |
|
269 |
266 |
$1K |
| 90651 |
|
338 |
336 |
$1K |
| 90656 |
|
252 |
252 |
$828.00 |
| 90685 |
|
114 |
112 |
$644.05 |
| 90680 |
|
81 |
80 |
$503.10 |
| 90620 |
|
138 |
137 |
$499.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,966 |
1,926 |
$472.76 |
| 90734 |
|
124 |
122 |
$442.40 |
| 92081 |
|
4,489 |
4,482 |
$297.25 |
| 90619 |
|
101 |
101 |
$279.00 |
| 96127 |
|
1,351 |
1,351 |
$267.41 |
| 90633 |
|
65 |
65 |
$234.00 |
| 90744 |
|
39 |
39 |
$198.00 |
| 90710 |
|
50 |
50 |
$161.10 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
20 |
12 |
$137.36 |
| 90671 |
|
14 |
12 |
$90.00 |
| 90674 |
|
22 |
20 |
$36.00 |
| D0120 |
Periodic oral evaluation - established patient |
95 |
95 |
$0.00 |
| 99172 |
|
51 |
51 |
$0.00 |
| Q2036 |
Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (flulaval) |
141 |
138 |
$0.00 |
| 97802 |
|
95 |
95 |
$0.00 |
| 92499 |
|
29 |
29 |
$0.00 |
| 90657 |
|
36 |
36 |
$0.00 |
| 99072 |
|
63 |
63 |
$0.00 |
| 99401 |
|
126 |
126 |
$0.00 |
| 90461 |
|
32 |
25 |
$0.00 |