| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
6,131 |
5,441 |
$249K |
| 96156 |
|
1,740 |
1,202 |
$147K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,666 |
1,663 |
$117K |
| 99383 |
|
1,383 |
1,380 |
$97K |
| 97802 |
|
3,183 |
3,174 |
$96K |
| 99384 |
|
1,117 |
1,116 |
$94K |
| 96150 |
|
2,937 |
2,306 |
$67K |
| 92551 |
|
2,803 |
2,791 |
$37K |
| 97803 |
|
1,238 |
1,229 |
$32K |
| 99382 |
|
455 |
455 |
$27K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
350 |
350 |
$25K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
391 |
390 |
$22K |
| 96151 |
|
955 |
946 |
$21K |
| 87110 |
|
886 |
880 |
$16K |
| 90686 |
|
1,611 |
1,608 |
$15K |
| G9920 |
Screening performed and negative |
503 |
503 |
$15K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
267 |
266 |
$13K |
| D1206 |
Topical application of fluoride varnish |
605 |
605 |
$11K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
635 |
635 |
$8K |
| 85018 |
|
3,390 |
3,376 |
$8K |
| 81002 |
|
2,379 |
2,365 |
$5K |
| 87070 |
|
643 |
638 |
$5K |
| 90734 |
|
365 |
364 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
115 |
115 |
$3K |
| 90651 |
|
332 |
332 |
$3K |
| 90620 |
|
252 |
251 |
$2K |
| 96127 |
|
469 |
462 |
$2K |
| 99188 |
|
125 |
125 |
$2K |
| 99173 |
|
78 |
78 |
$2K |
| 99385 |
|
12 |
12 |
$2K |
| 99381 |
|
28 |
28 |
$2K |
| 90670 |
|
169 |
167 |
$2K |
| 90698 |
|
153 |
152 |
$1K |
| 90688 |
|
144 |
144 |
$1K |
| 99215 |
Prolong outpt/office vis |
19 |
15 |
$1K |
| 92552 |
|
76 |
76 |
$1K |
| 90715 |
|
97 |
96 |
$900.51 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
112 |
110 |
$761.91 |
| 90649 |
|
80 |
80 |
$711.00 |
| 90710 |
|
79 |
78 |
$711.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
20 |
20 |
$686.80 |
| 90680 |
|
70 |
69 |
$630.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
53 |
53 |
$567.10 |
| 90685 |
|
62 |
62 |
$566.44 |
| 90633 |
|
55 |
54 |
$495.00 |
| 83655 |
|
33 |
33 |
$371.25 |
| 81007 |
|
79 |
79 |
$192.51 |
| 90744 |
|
12 |
12 |
$122.26 |
| 90696 |
|
13 |
13 |
$117.00 |