| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
3,810 |
3,512 |
$111K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
5,319 |
4,747 |
$63K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,768 |
1,608 |
$56K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
614 |
546 |
$19K |
| D1206 |
Topical application of fluoride varnish |
648 |
544 |
$17K |
| 96127 |
|
752 |
726 |
$11K |
| 90688 |
|
267 |
239 |
$3K |
| 36416 |
|
804 |
699 |
$3K |
| H1000 |
Prenatal care, at-risk assessment |
181 |
174 |
$3K |
| 0012A |
|
52 |
52 |
$2K |
| 0011A |
|
58 |
58 |
$2K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
109 |
98 |
$2K |
| 99381 |
|
26 |
26 |
$844.45 |
| 90734 |
|
54 |
43 |
$727.75 |
| 90670 |
|
14 |
12 |
$304.93 |
| 90671 |
|
14 |
13 |
$250.39 |
| 90715 |
|
17 |
14 |
$112.00 |
| 90723 |
|
14 |
12 |
$89.60 |
| 85018 |
|
37 |
26 |
$85.84 |
| 91301 |
|
102 |
102 |
$0.00 |