| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
514 |
512 |
$22K |
| 90686 |
|
1,636 |
1,623 |
$19K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
466 |
459 |
$12K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
594 |
585 |
$10K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
412 |
404 |
$6K |
| 92552 |
|
1,817 |
1,784 |
$4K |
| G9920 |
Screening performed and negative |
895 |
890 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,493 |
5,148 |
$3K |
| 90649 |
|
260 |
248 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
250 |
247 |
$2K |
| 90707 |
|
300 |
292 |
$2K |
| 90734 |
|
102 |
98 |
$1K |
| 90716 |
|
115 |
109 |
$587.19 |
| 90756 |
|
37 |
36 |
$480.64 |
| 90713 |
|
99 |
97 |
$357.12 |
| 90744 |
|
33 |
33 |
$297.60 |
| 90700 |
|
82 |
80 |
$248.00 |
| 90651 |
|
29 |
29 |
$218.24 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
606 |
592 |
$148.39 |
| 97803 |
|
315 |
314 |
$143.95 |
| 90715 |
|
65 |
58 |
$128.96 |
| 99429 |
|
720 |
708 |
$110.00 |
| 90670 |
|
31 |
29 |
$79.36 |
| 90688 |
|
417 |
412 |
$44.43 |
| 90620 |
|
29 |
28 |
$29.76 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
388 |
376 |
$8.92 |
| 81002 |
|
1,517 |
1,491 |
$8.72 |
| 90461 |
|
187 |
130 |
$8.47 |
| 86580 |
|
61 |
57 |
$3.36 |
| 99173 |
|
1,486 |
1,461 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
17 |
17 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
61 |
59 |
$0.00 |
| G9604 |
Patient survey results not available |
20 |
18 |
$0.00 |