| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H0041 |
Foster care, child, non-therapeutic, per diem |
13,144 |
11,538 |
$4.52M |
| S5145 |
Foster care, therapeutic, child; per diem |
4,243 |
3,222 |
$4.05M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
276 |
263 |
$60K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
252 |
239 |
$40K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
317 |
307 |
$20K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
43 |
43 |
$12K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
362 |
358 |
$11K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
30 |
30 |
$10K |
| 96137 |
|
19 |
19 |
$5K |
| 96127 |
|
70 |
70 |
$5K |
| 96130 |
|
18 |
18 |
$4K |
| 96131 |
|
17 |
17 |
$4K |
| 90791 |
Psychiatric diagnostic evaluation |
24 |
24 |
$4K |
| 96136 |
|
19 |
19 |
$2K |
| 92551 |
|
160 |
159 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
13 |
13 |
$303.45 |
| 90686 |
|
89 |
89 |
$0.00 |
| 99173 |
|
12 |
12 |
$0.00 |