| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
4,278 |
3,554 |
$49K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,600 |
1,489 |
$25K |
| 96127 |
|
1,156 |
758 |
$18K |
| 90686 |
|
459 |
429 |
$6K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
328 |
277 |
$5K |
| 0011A |
|
149 |
125 |
$5K |
| D1206 |
Topical application of fluoride varnish |
166 |
146 |
$4K |
| 91320 |
|
27 |
13 |
$3K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
46 |
38 |
$3K |
| 0012A |
|
68 |
66 |
$3K |
| 83655 |
|
198 |
170 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
21 |
12 |
$2K |
| 90656 |
|
107 |
91 |
$2K |
| 0064A |
|
37 |
37 |
$2K |
| 99000 |
|
66 |
51 |
$1K |
| 36416 |
|
339 |
257 |
$1K |
| 0502F |
|
26 |
12 |
$926.10 |
| 85018 |
|
303 |
268 |
$700.64 |
| H1000 |
Prenatal care, at-risk assessment |
50 |
26 |
$696.60 |
| 90734 |
|
37 |
37 |
$629.05 |
| 0031A |
|
14 |
14 |
$589.96 |
| 90619 |
|
34 |
33 |
$568.14 |
| 96160 |
|
35 |
23 |
$511.00 |
| 90715 |
|
13 |
12 |
$230.65 |
| 91301 |
|
172 |
166 |
$0.00 |