| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
3,115 |
2,742 |
$47K |
| 96127 |
|
2,376 |
2,134 |
$32K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,975 |
1,546 |
$20K |
| H1000 |
Prenatal care, at-risk assessment |
1,269 |
1,152 |
$18K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
854 |
753 |
$12K |
| 85018 |
|
2,619 |
2,152 |
$6K |
| 0012A |
|
118 |
107 |
$5K |
| 90686 |
|
447 |
366 |
$5K |
| 36416 |
|
971 |
782 |
$4K |
| 0011A |
|
96 |
88 |
$4K |
| 0002A |
|
54 |
50 |
$2K |
| 0001A |
|
53 |
49 |
$2K |
| 92551 |
|
45 |
40 |
$460.90 |
| D1206 |
Topical application of fluoride varnish |
14 |
14 |
$364.00 |
| 99173 |
|
44 |
39 |
$320.35 |
| 90734 |
|
15 |
15 |
$96.00 |
| 91301 |
|
235 |
230 |
$0.00 |
| 91300 |
|
99 |
91 |
$0.00 |