| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,173 |
2,962 |
$72K |
| 96156 |
|
1,137 |
1,095 |
$44K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
506 |
506 |
$20K |
| G9920 |
Screening performed and negative |
925 |
876 |
$9K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
146 |
132 |
$7K |
| 92551 |
|
795 |
794 |
$4K |
| 36415 |
Collection of venous blood by venipuncture |
107 |
107 |
$2K |
| D1206 |
Topical application of fluoride varnish |
83 |
65 |
$2K |
| 90658 |
|
185 |
185 |
$2K |
| 97802 |
|
130 |
122 |
$1K |
| 85999 |
|
316 |
316 |
$951.16 |
| 90686 |
|
205 |
204 |
$910.00 |
| 99173 |
|
350 |
349 |
$894.17 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
139 |
139 |
$495.11 |
| 90670 |
|
52 |
51 |
$468.00 |
| 90698 |
|
50 |
50 |
$450.00 |
| 90700 |
|
103 |
103 |
$414.00 |
| 90680 |
|
46 |
46 |
$405.00 |
| 96167 |
|
732 |
709 |
$362.94 |
| 94760 |
|
88 |
88 |
$346.08 |
| 90744 |
|
31 |
31 |
$180.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
170 |
170 |
$144.69 |
| 90656 |
|
264 |
264 |
$117.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
156 |
156 |
$113.14 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
390 |
259 |
$70.82 |
| 90671 |
|
92 |
91 |
$45.00 |
| 97803 |
|
656 |
646 |
$26.11 |
| 90707 |
|
27 |
27 |
$18.00 |
| 99188 |
|
662 |
662 |
$18.00 |
| 90651 |
|
30 |
30 |
$18.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
179 |
179 |
$10.70 |
| 90633 |
|
37 |
37 |
$9.00 |
| 90716 |
|
27 |
27 |
$9.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
469 |
422 |
$0.00 |
| 80061 |
Lipid panel |
139 |
139 |
$0.00 |
| 96158 |
|
156 |
156 |
$0.00 |
| 90461 |
|
15 |
15 |
$0.00 |
| 96127 |
|
110 |
110 |
$0.00 |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
122 |
122 |
$0.00 |