| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
4,370 |
3,892 |
$116K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
4,288 |
3,870 |
$50K |
| D1206 |
Topical application of fluoride varnish |
1,052 |
964 |
$27K |
| 90670 |
|
2,091 |
1,962 |
$23K |
| 90723 |
|
1,957 |
1,745 |
$21K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
619 |
532 |
$20K |
| 90647 |
|
1,839 |
1,660 |
$19K |
| 90686 |
|
1,308 |
1,216 |
$16K |
| 90734 |
|
802 |
733 |
$14K |
| 90680 |
|
1,138 |
1,031 |
$11K |
| 96127 |
|
756 |
695 |
$11K |
| 90715 |
|
501 |
456 |
$8K |
| 90677 |
|
400 |
320 |
$7K |
| 90633 |
|
365 |
331 |
$4K |
| 90710 |
|
278 |
259 |
$4K |
| 36416 |
|
957 |
893 |
$4K |
| 0012A |
|
123 |
100 |
$4K |
| 90696 |
|
249 |
232 |
$3K |
| 90716 |
|
196 |
166 |
$3K |
| 99381 |
|
88 |
79 |
$3K |
| 83655 |
|
209 |
183 |
$2K |
| H1000 |
Prenatal care, at-risk assessment |
168 |
160 |
$2K |
| 0011A |
|
123 |
104 |
$2K |
| 0064A |
|
60 |
48 |
$2K |
| 90707 |
|
182 |
154 |
$2K |
| 85018 |
|
835 |
826 |
$2K |
| 0134A |
|
31 |
30 |
$1K |
| 90656 |
|
64 |
59 |
$1K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
74 |
62 |
$992.20 |
| 90700 |
|
88 |
86 |
$842.28 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
28 |
27 |
$804.60 |
| 90651 |
|
32 |
27 |
$570.91 |
| 92558 |
|
42 |
39 |
$499.87 |
| 0002A |
|
16 |
16 |
$480.00 |
| 0001A |
|
19 |
16 |
$421.22 |
| 90620 |
|
14 |
12 |
$225.64 |
| 90681 |
|
14 |
13 |
$83.20 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
34 |
30 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
88 |
78 |
$0.00 |