| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
2,143 |
2,132 |
$30K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
2,399 |
2,351 |
$29K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
2,065 |
2,024 |
$27K |
| 92552 |
|
4,964 |
4,899 |
$18K |
| 90656 |
|
2,649 |
2,455 |
$16K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,256 |
1,197 |
$15K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,804 |
1,120 |
$13K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
8,141 |
7,367 |
$10K |
| 87110 |
|
1,137 |
1,132 |
$4K |
| 92002 |
|
2,835 |
2,809 |
$3K |
| 90700 |
|
531 |
501 |
$3K |
| 3074F |
|
2,596 |
2,557 |
$3K |
| 3078F |
|
2,569 |
2,531 |
$2K |
| 83020 |
|
459 |
458 |
$2K |
| 97803 |
|
5,295 |
5,176 |
$2K |
| 81002 |
|
2,308 |
2,252 |
$2K |
| 90649 |
|
413 |
406 |
$2K |
| 81000 |
|
3,599 |
3,554 |
$2K |
| 99173 |
|
827 |
827 |
$2K |
| 86580 |
|
1,422 |
1,392 |
$2K |
| 85014 |
|
4,391 |
4,296 |
$2K |
| 90734 |
|
362 |
361 |
$2K |
| 90660 |
|
219 |
214 |
$2K |
| 90713 |
|
294 |
276 |
$1K |
| 87070 |
|
957 |
954 |
$1K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
554 |
548 |
$1K |
| 90716 |
|
248 |
243 |
$1K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
106 |
105 |
$1K |
| 90707 |
|
147 |
143 |
$1K |
| 83026 |
|
532 |
530 |
$908.30 |
| 90670 |
|
176 |
162 |
$765.00 |
| 90647 |
|
191 |
176 |
$729.40 |
| 82465 |
|
710 |
708 |
$722.59 |
| 90621 |
|
69 |
69 |
$674.62 |
| 90655 |
|
452 |
437 |
$657.00 |
| 90715 |
|
86 |
85 |
$422.66 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
598 |
580 |
$413.72 |
| 99383 |
|
209 |
204 |
$399.54 |
| 99384 |
|
184 |
179 |
$376.27 |
| 83655 |
|
71 |
66 |
$343.20 |
| 97802 |
|
191 |
189 |
$248.24 |
| 96127 |
|
1,039 |
1,038 |
$221.33 |
| 87081 |
|
230 |
225 |
$181.19 |
| 90633 |
|
65 |
63 |
$171.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
13 |
12 |
$161.00 |
| 90680 |
|
13 |
13 |
$117.00 |
| 92551 |
|
723 |
707 |
$60.97 |
| 99382 |
|
31 |
31 |
$46.66 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
579 |
567 |
$34.00 |
| 99406 |
|
1,015 |
1,015 |
$28.11 |
| 99401 |
|
124 |
121 |
$27.00 |
| 99408 |
|
721 |
721 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
224 |
220 |
$0.00 |
| 90685 |
|
282 |
278 |
$0.00 |
| 90658 |
|
284 |
278 |
$0.00 |
| 96160 |
|
14 |
14 |
$0.00 |
| 90674 |
|
282 |
278 |
$0.00 |
| 96161 |
|
1,112 |
1,097 |
$0.00 |
| 99443 |
|
676 |
644 |
$0.00 |
| 90688 |
|
282 |
278 |
$0.00 |
| 81005 |
|
705 |
689 |
$0.00 |
| 80053 |
Comprehensive metabolic panel |
487 |
487 |
$0.00 |
| 90686 |
|
282 |
278 |
$0.00 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
31 |
31 |
$0.00 |