| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G9920 |
Screening performed and negative |
19,810 |
19,747 |
$345K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
40,692 |
38,131 |
$281K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
4,651 |
4,593 |
$220K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
7,843 |
7,831 |
$200K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
9,332 |
9,310 |
$196K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
8,150 |
8,113 |
$152K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
44,588 |
25,156 |
$114K |
| 92552 |
|
6,300 |
6,286 |
$74K |
| 92551 |
|
18,018 |
17,990 |
$50K |
| 90686 |
|
9,272 |
9,245 |
$38K |
| 90700 |
|
6,484 |
6,420 |
$33K |
| 3008F |
|
18,416 |
18,095 |
$29K |
| 90713 |
|
5,158 |
5,124 |
$27K |
| 3078F |
|
17,832 |
17,570 |
$26K |
| 3074F |
|
17,810 |
17,545 |
$26K |
| 90647 |
|
4,596 |
4,514 |
$24K |
| 0071A |
|
596 |
596 |
$24K |
| 90670 |
|
3,924 |
3,905 |
$22K |
| 0072A |
|
538 |
538 |
$22K |
| 0002A |
|
450 |
449 |
$18K |
| 99381 |
|
198 |
176 |
$18K |
| D1206 |
Topical application of fluoride varnish |
1,666 |
1,663 |
$17K |
| 0001A |
|
415 |
412 |
$16K |
| 90651 |
|
2,797 |
2,786 |
$16K |
| 99173 |
|
6,229 |
6,215 |
$15K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,885 |
1,881 |
$15K |
| 92081 |
|
14,404 |
14,394 |
$14K |
| 99460 |
|
322 |
322 |
$13K |
| 90680 |
|
2,358 |
2,348 |
$13K |
| 0054A |
|
261 |
261 |
$10K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
2,350 |
2,336 |
$8K |
| 90461 |
|
8,772 |
7,800 |
$7K |
| 0004A |
|
161 |
160 |
$6K |
| 90744 |
|
1,255 |
1,246 |
$5K |
| 90716 |
|
1,120 |
1,118 |
$5K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
183 |
183 |
$5K |
| 90707 |
|
994 |
993 |
$5K |
| 81000 |
|
6,187 |
6,157 |
$4K |
| 0124A |
|
108 |
108 |
$4K |
| 90633 |
|
1,066 |
1,064 |
$4K |
| 81003 |
|
1,671 |
1,666 |
$4K |
| 99384 |
|
74 |
74 |
$4K |
| 90734 |
|
865 |
865 |
$4K |
| 90480 |
|
132 |
93 |
$3K |
| 90620 |
|
1,211 |
1,211 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
400 |
390 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
476 |
471 |
$3K |
| 99383 |
|
57 |
57 |
$2K |
| 90688 |
|
846 |
843 |
$2K |
| 90715 |
|
530 |
527 |
$2K |
| 90619 |
|
539 |
535 |
$2K |
| 90685 |
|
411 |
399 |
$2K |
| 0154A |
|
38 |
38 |
$2K |
| 90677 |
|
363 |
356 |
$1K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
3,115 |
3,114 |
$1K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
38 |
27 |
$963.65 |
| 85018 |
|
2,057 |
2,055 |
$926.68 |
| 0052A |
|
17 |
17 |
$680.00 |
| 96127 |
|
1,699 |
1,695 |
$604.29 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
286 |
286 |
$564.52 |
| 90660 |
|
142 |
139 |
$499.68 |
| 0074A |
|
12 |
12 |
$480.00 |
| 83026 |
|
133 |
133 |
$351.00 |
| 90656 |
|
70 |
70 |
$324.00 |
| 91322 |
|
41 |
23 |
$145.92 |
| 87810 |
|
380 |
380 |
$140.00 |
| 96160 |
|
17,715 |
17,107 |
$88.36 |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
746 |
746 |
$34.28 |
| 69210 |
|
25 |
25 |
$30.22 |
| H0049 |
Alcohol and/or drug screening |
1,062 |
1,061 |
$13.50 |
| 91321 |
|
32 |
20 |
$0.00 |
| 99401 |
|
1,046 |
1,045 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
35 |
34 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
1,049 |
1,048 |
$0.00 |
| 85032 |
|
138 |
138 |
$0.00 |
| 1036F |
|
329 |
328 |
$0.00 |
| 99172 |
|
518 |
518 |
$0.00 |
| 97802 |
|
1,047 |
1,046 |
$0.00 |
| 90657 |
|
164 |
164 |
$0.00 |
| 99441 |
|
17 |
17 |
$0.00 |