| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G0451 |
Development testing, with interpretation and report, per standardized instrument form |
7,109 |
6,757 |
$406K |
| D0190 |
|
19,890 |
19,061 |
$303K |
| D1206 |
Topical application of fluoride varnish |
18,795 |
17,948 |
$251K |
| D1330 |
|
10,874 |
10,467 |
$164K |
| 83655 |
|
7,322 |
6,895 |
$135K |
| S9123 |
Nursing care, in the home; by registered nurse, per hour (use for general nursing care only, not to be used when cpt codes 99500-99602 can be used) |
844 |
541 |
$93K |
| 96127 |
|
1,593 |
1,530 |
$81K |
| D1351 |
Sealant - per tooth |
2,101 |
1,082 |
$69K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,843 |
1,471 |
$49K |
| T1013 |
Sign language or oral interpretive services, per 15 minutes |
1,665 |
1,458 |
$44K |
| D0602 |
|
18,969 |
18,113 |
$16K |
| D0145 |
Oral evaluation for a patient under three years of age |
940 |
848 |
$15K |
| D0603 |
|
1,817 |
1,752 |
$2K |
| H0046 |
Mental health services, not otherwise specified |
19 |
13 |
$951.43 |
| D9990 |
|
64 |
64 |
$920.96 |
| 90686 |
|
815 |
783 |
$513.92 |
| 0001A |
|
13 |
12 |
$480.00 |
| 96161 |
|
424 |
227 |
$458.64 |
| 90734 |
|
125 |
119 |
$320.93 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
20 |
20 |
$317.64 |
| 85018 |
|
136 |
124 |
$204.72 |
| 99174 |
|
12 |
12 |
$162.36 |
| 90656 |
|
44 |
44 |
$112.21 |
| H1003 |
Prenatal care, at-risk enhanced service; education |
19 |
13 |
$81.36 |
| 99173 |
|
25 |
24 |
$41.80 |
| D0601 |
|
34 |
34 |
$29.76 |
| 90461 |
|
259 |
242 |
$2.12 |
| 90715 |
|
66 |
63 |
$0.13 |
| 90651 |
|
37 |
35 |
$0.07 |
| 91300 |
|
20 |
17 |
$0.00 |