| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
38 |
38 |
$2K |
| G9920 |
Screening performed and negative |
51 |
51 |
$2K |
| 90686 |
|
128 |
127 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$848.76 |
| 96151 |
|
12 |
12 |
$270.00 |
| 96156 |
|
12 |
12 |
$178.20 |
| 92551 |
|
13 |
13 |
$171.08 |
| 81000 |
|
40 |
38 |
$98.55 |
| 85018 |
|
29 |
27 |
$41.28 |
| 97803 |
|
183 |
176 |
$26.11 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
97 |
88 |
$0.00 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
142 |
137 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
132 |
129 |
$0.00 |
| 99173 |
|
13 |
13 |
$0.00 |