| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
7,488 |
7,018 |
$132K |
| 99460 |
|
1,518 |
1,516 |
$73K |
| 92552 |
|
4,091 |
4,086 |
$66K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
1,415 |
1,412 |
$55K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
5,661 |
5,168 |
$37K |
| 99381 |
|
738 |
728 |
$26K |
| 90670 |
|
3,995 |
3,978 |
$15K |
| D1206 |
Topical application of fluoride varnish |
1,008 |
1,006 |
$14K |
| 99462 |
|
493 |
413 |
$13K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,381 |
3,226 |
$12K |
| 90723 |
|
3,823 |
3,799 |
$12K |
| 96156 |
|
3,325 |
3,075 |
$10K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
4,617 |
4,608 |
$7K |
| 90677 |
|
700 |
697 |
$6K |
| 90680 |
|
3,272 |
3,249 |
$5K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
685 |
639 |
$5K |
| 90648 |
|
4,008 |
3,974 |
$5K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,119 |
1,085 |
$3K |
| 99383 |
|
637 |
637 |
$2K |
| 99441 |
|
680 |
659 |
$1K |
| 99382 |
|
495 |
493 |
$1K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
79 |
79 |
$1K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,091 |
1,081 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,018 |
1,018 |
$1K |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
3,325 |
3,323 |
$879.10 |
| 83655 |
|
936 |
935 |
$700.62 |
| G9920 |
Screening performed and negative |
1,771 |
1,768 |
$491.26 |
| 90633 |
|
2,122 |
2,118 |
$331.83 |
| 90686 |
|
1,480 |
1,479 |
$228.91 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
212 |
212 |
$217.12 |
| 96150 |
|
14 |
14 |
$142.80 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
690 |
689 |
$135.03 |
| 90716 |
|
1,169 |
1,166 |
$134.37 |
| 90707 |
|
1,159 |
1,157 |
$134.37 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
63 |
63 |
$123.58 |
| 85018 |
|
854 |
852 |
$111.75 |
| 90700 |
|
899 |
898 |
$96.39 |
| 97802 |
|
12 |
12 |
$90.15 |
| 90710 |
|
442 |
442 |
$26.91 |
| 90696 |
|
382 |
382 |
$17.91 |
| 90651 |
|
91 |
91 |
$9.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
314 |
310 |
$4.42 |
| 3008F |
|
15 |
15 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
37 |
36 |
$0.00 |
| H0049 |
Alcohol and/or drug screening |
58 |
58 |
$0.00 |
| 96160 |
|
1,767 |
1,720 |
$0.00 |
| G0438 |
Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit |
3,444 |
3,442 |
$0.00 |
| 90715 |
|
14 |
14 |
$0.00 |
| G0270 |
Medical nutrition therapy; reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition or treatment regimen (including additional hours needed for renal disease), individual, face to face with the patient, each 15 minutes |
67 |
67 |
$0.00 |
| 99173 |
|
103 |
103 |
$0.00 |
| 90734 |
|
63 |
63 |
$0.00 |
| 90461 |
|
218 |
218 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
247 |
241 |
$0.00 |
| 99408 |
|
15 |
15 |
$0.00 |
| 90685 |
|
94 |
94 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
33 |
32 |
$0.00 |