| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
803 |
800 |
$46K |
| 96156 |
|
437 |
431 |
$32K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
687 |
672 |
$27K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,702 |
1,356 |
$27K |
| 92551 |
|
1,169 |
1,159 |
$14K |
| 96151 |
|
338 |
337 |
$7K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
86 |
83 |
$6K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
121 |
121 |
$6K |
| G9920 |
Screening performed and negative |
398 |
398 |
$4K |
| 97802 |
|
622 |
621 |
$4K |
| 81000 |
|
1,159 |
1,149 |
$3K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
226 |
185 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
42 |
33 |
$3K |
| 99173 |
|
571 |
562 |
$2K |
| 85999 |
|
601 |
590 |
$2K |
| 90686 |
|
164 |
164 |
$1K |
| 85018 |
|
636 |
635 |
$1K |
| 90658 |
|
70 |
70 |
$630.00 |
| 86580 |
|
113 |
103 |
$576.40 |
| 90672 |
|
55 |
55 |
$468.00 |
| 90716 |
|
27 |
26 |
$343.41 |
| 90715 |
|
30 |
26 |
$234.00 |
| 90734 |
|
28 |
27 |
$234.00 |
| 90688 |
|
17 |
17 |
$153.00 |
| 96127 |
|
185 |
185 |
$148.05 |
| 90674 |
|
14 |
14 |
$126.00 |
| 90713 |
|
12 |
12 |
$108.00 |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
27 |
27 |
$33.00 |
| 81001 |
|
54 |
54 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
27 |
17 |
$0.00 |