| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
184 |
184 |
$9K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
165 |
165 |
$6K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
162 |
161 |
$6K |
| 83655 |
|
71 |
70 |
$746.92 |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
28 |
28 |
$485.24 |
| 90700 |
|
157 |
150 |
$433.44 |
| 90713 |
|
123 |
117 |
$402.42 |
| 90648 |
|
132 |
129 |
$360.00 |
| 90744 |
|
116 |
110 |
$360.00 |
| 90670 |
|
117 |
112 |
$333.00 |
| 92551 |
|
29 |
29 |
$292.90 |
| 90680 |
|
86 |
81 |
$252.00 |
| 85018 |
|
121 |
120 |
$248.05 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
107 |
104 |
$190.08 |
| 90633 |
|
70 |
66 |
$189.00 |
| 90707 |
|
27 |
26 |
$176.29 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
245 |
244 |
$4.42 |
| 81002 |
|
26 |
26 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
207 |
207 |
$0.00 |
| 92081 |
|
29 |
29 |
$0.00 |