| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
653 |
626 |
$35K |
| 92552 |
|
1,269 |
1,210 |
$17K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
129 |
125 |
$6K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
144 |
130 |
$4K |
| 90686 |
|
305 |
295 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
37 |
37 |
$1K |
| 90688 |
|
81 |
55 |
$396.80 |
| 90700 |
|
52 |
50 |
$347.20 |
| 90716 |
|
28 |
28 |
$238.08 |
| 90713 |
|
28 |
26 |
$178.56 |
| 90734 |
|
12 |
12 |
$109.12 |
| 90651 |
|
12 |
12 |
$69.44 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
449 |
425 |
$41.34 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
215 |
207 |
$16.94 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
586 |
557 |
$0.00 |
| 99173 |
|
31 |
28 |
$0.00 |
| 69210 |
|
18 |
14 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
33 |
31 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
15 |
15 |
$0.00 |