| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 96156 |
|
253 |
247 |
$27K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
633 |
572 |
$18K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
152 |
148 |
$7K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
55 |
53 |
$1K |
| 90686 |
|
96 |
95 |
$837.00 |
| 96151 |
|
15 |
15 |
$337.50 |
| 85018 |
|
108 |
108 |
$222.30 |
| 92551 |
|
12 |
12 |
$178.44 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
470 |
236 |
$0.00 |
| 99173 |
|
25 |
25 |
$0.00 |
| 1159F |
|
57 |
38 |
$0.00 |
| 3078F |
|
19 |
13 |
$0.00 |
| 98960 |
|
14 |
13 |
$0.00 |
| 90461 |
|
13 |
12 |
$0.00 |
| G9903 |
Patient screened for tobacco use and identified as a tobacco non-user |
12 |
12 |
$0.00 |
| 3074F |
|
18 |
12 |
$0.00 |