| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,241 |
1,198 |
$36K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
893 |
851 |
$30K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
687 |
607 |
$25K |
| 92567 |
|
1,140 |
1,107 |
$17K |
| 92551 |
|
1,274 |
1,237 |
$16K |
| D1208 |
Topical application of fluoride, excluding varnish |
713 |
696 |
$13K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
89 |
88 |
$6K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
73 |
71 |
$5K |
| 99173 |
|
190 |
187 |
$920.25 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
12 |
12 |
$90.00 |
| 90686 |
|
350 |
333 |
$0.00 |