| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
464 |
394 |
$26K |
| 96156 |
|
317 |
314 |
$21K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
579 |
518 |
$12K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
245 |
213 |
$6K |
| 97802 |
|
250 |
239 |
$2K |
| G9920 |
Screening performed and negative |
195 |
195 |
$2K |
| 92551 |
|
114 |
107 |
$1K |
| 85018 |
|
402 |
391 |
$686.97 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$578.76 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
15 |
15 |
$385.71 |
| 90698 |
|
13 |
13 |
$117.00 |
| 90670 |
|
12 |
12 |
$108.00 |
| 90686 |
|
15 |
15 |
$99.00 |
| 99173 |
|
16 |
16 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
19 |
12 |
$0.00 |
| 36416 |
|
58 |
47 |
$0.00 |
| 96127 |
|
12 |
12 |
$0.00 |