| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,492 |
1,443 |
$15K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
267 |
265 |
$15K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
91 |
91 |
$10K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
202 |
202 |
$9K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
170 |
170 |
$9K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
53 |
53 |
$4K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
41 |
41 |
$3K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
298 |
298 |
$3K |
| 90461 |
|
66 |
66 |
$2K |
| 92558 |
|
111 |
111 |
$845.70 |
| 99188 |
|
29 |
29 |
$699.40 |
| 99177 |
|
153 |
153 |
$569.16 |
| 99051 |
|
28 |
28 |
$463.68 |
| 96127 |
|
32 |
32 |
$328.64 |