| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,712 |
1,650 |
$27K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,789 |
2,634 |
$21K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,520 |
3,064 |
$20K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,914 |
1,687 |
$16K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,292 |
1,226 |
$14K |
| 90686 |
|
741 |
705 |
$9K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
532 |
459 |
$6K |
| 92567 |
|
300 |
267 |
$5K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
452 |
436 |
$4K |
| 90670 |
|
183 |
174 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
240 |
237 |
$2K |
| 90647 |
|
105 |
103 |
$2K |
| 90723 |
|
65 |
65 |
$1K |
| 90685 |
|
26 |
26 |
$549.00 |
| 90633 |
|
25 |
25 |
$540.92 |
| 96160 |
|
181 |
166 |
$478.03 |
| 99215 |
Prolong outpt/office vis |
12 |
12 |
$350.81 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
115 |
105 |
$295.50 |
| 90656 |
|
16 |
16 |
$0.00 |