| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
746 |
479 |
$30K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
464 |
394 |
$29K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
594 |
547 |
$25K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
246 |
240 |
$17K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
245 |
232 |
$16K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
347 |
333 |
$7K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
471 |
457 |
$5K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
46 |
46 |
$3K |
| 99460 |
|
27 |
26 |
$1K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
27 |
25 |
$1K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
91 |
90 |
$910.94 |
| 90670 |
|
257 |
249 |
$807.21 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
40 |
40 |
$605.60 |
| 90716 |
|
42 |
41 |
$460.00 |
| 90707 |
|
45 |
44 |
$417.48 |
| 36416 |
|
62 |
61 |
$178.39 |
| 90633 |
|
34 |
33 |
$129.22 |
| 90647 |
|
153 |
151 |
$34.80 |
| 90685 |
|
48 |
48 |
$23.79 |
| 90723 |
|
111 |
110 |
$0.00 |
| 90688 |
|
26 |
26 |
$0.00 |