| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
117,020 |
107,568 |
$18.22M |
| D1206 |
Topical application of fluoride varnish |
10,777 |
10,685 |
$199K |
| G9920 |
Screening performed and negative |
5,496 |
5,419 |
$195K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
42,804 |
39,930 |
$161K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
7,074 |
6,928 |
$133K |
| 99173 |
|
23,081 |
22,834 |
$101K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,938 |
1,930 |
$63K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
7,062 |
7,034 |
$63K |
| 99188 |
|
2,419 |
2,395 |
$52K |
| 0001A |
|
777 |
390 |
$41K |
| 0002A |
|
680 |
343 |
$35K |
| 92081 |
|
709 |
700 |
$29K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
10,549 |
10,427 |
$29K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
9,100 |
8,821 |
$24K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
7,813 |
7,753 |
$17K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
6,642 |
6,155 |
$17K |
| 99381 |
|
267 |
266 |
$13K |
| 92551 |
|
22,844 |
22,711 |
$11K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
4,754 |
4,708 |
$11K |
| 90686 |
|
16,749 |
16,651 |
$6K |
| 0072A |
|
110 |
103 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
313 |
302 |
$4K |
| 88720 |
|
582 |
460 |
$3K |
| 91320 |
|
20 |
12 |
$3K |
| 90670 |
|
6,389 |
6,329 |
$1K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
37 |
33 |
$594.96 |
| 0071A |
|
15 |
14 |
$560.00 |
| G9919 |
Screening performed and positive and provision of recommendations |
15 |
15 |
$543.46 |
| 90619 |
|
661 |
660 |
$529.80 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
67 |
67 |
$461.34 |
| 90697 |
|
677 |
667 |
$389.62 |
| 81002 |
|
95 |
92 |
$335.56 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
13 |
12 |
$307.19 |
| 90723 |
|
3,288 |
3,257 |
$286.86 |
| 90677 |
|
356 |
355 |
$257.85 |
| 90647 |
|
1,613 |
1,599 |
$240.80 |
| 90651 |
|
2,997 |
2,977 |
$232.82 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
342 |
336 |
$225.00 |
| 90680 |
|
1,529 |
1,513 |
$154.95 |
| 90696 |
|
724 |
711 |
$147.01 |
| 90715 |
|
730 |
726 |
$137.99 |
| 90710 |
|
788 |
774 |
$128.14 |
| 90707 |
|
491 |
485 |
$122.69 |
| 90716 |
|
578 |
573 |
$118.57 |
| 90700 |
|
475 |
472 |
$115.31 |
| 86580 |
|
33 |
29 |
$110.88 |
| 99384 |
|
25 |
25 |
$82.88 |
| 90648 |
|
1,422 |
1,406 |
$79.50 |
| 99383 |
|
36 |
36 |
$69.09 |
| 90633 |
|
583 |
581 |
$45.51 |
| 90734 |
|
1,559 |
1,544 |
$38.70 |
| 90681 |
|
122 |
120 |
$28.80 |
| 90620 |
|
483 |
482 |
$26.90 |
| 85018 |
|
12 |
12 |
$13.62 |
| 90685 |
|
404 |
404 |
$9.27 |
| 1159F |
|
17 |
16 |
$0.00 |
| 90634 |
|
140 |
140 |
$0.00 |
| 3008F |
|
146 |
146 |
$0.00 |
| 90660 |
|
12 |
12 |
$0.00 |
| 96127 |
|
117 |
117 |
$0.00 |
| 90674 |
|
116 |
116 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
51 |
51 |
$0.00 |