| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 96156 |
|
1,159 |
1,079 |
$76K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,089 |
1,087 |
$71K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
646 |
628 |
$21K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
324 |
318 |
$14K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
281 |
280 |
$13K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
189 |
189 |
$13K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
234 |
234 |
$13K |
| 92551 |
|
514 |
514 |
$7K |
| 90670 |
|
244 |
244 |
$2K |
| 90698 |
|
240 |
240 |
$2K |
| 90744 |
|
149 |
149 |
$1K |
| 90680 |
|
130 |
130 |
$1K |
| 90686 |
|
126 |
126 |
$1K |
| 99381 |
|
19 |
19 |
$1K |
| 90633 |
|
107 |
107 |
$963.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
164 |
163 |
$923.10 |
| 90716 |
|
83 |
83 |
$747.00 |
| 90707 |
|
78 |
78 |
$702.00 |
| 90685 |
|
50 |
50 |
$481.60 |
| 90696 |
|
26 |
26 |
$234.00 |
| 90651 |
|
15 |
15 |
$135.00 |
| 90660 |
|
13 |
13 |
$117.00 |
| G9920 |
Screening performed and negative |
33 |
33 |
$58.00 |
| 97802 |
|
25 |
25 |
$30.35 |
| H1003 |
Prenatal care, at-risk enhanced service; education |
38 |
38 |
$1.00 |
| 99172 |
|
168 |
168 |
$0.00 |
| 99050 |
|
143 |
142 |
$0.00 |
| 99173 |
|
292 |
292 |
$0.00 |