| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
5,197 |
4,121 |
$61K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
824 |
686 |
$46K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,811 |
1,658 |
$29K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
515 |
447 |
$16K |
| 96127 |
|
975 |
927 |
$14K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
182 |
168 |
$6K |
| 90686 |
|
409 |
350 |
$6K |
| D1206 |
Topical application of fluoride varnish |
171 |
150 |
$4K |
| 36416 |
|
1,042 |
893 |
$4K |
| S4993 |
Contraceptive pills for birth control |
76 |
67 |
$3K |
| 99381 |
|
68 |
66 |
$2K |
| 90734 |
|
150 |
133 |
$2K |
| H1000 |
Prenatal care, at-risk assessment |
144 |
141 |
$2K |
| 85018 |
|
408 |
306 |
$900.16 |
| 81002 |
|
156 |
120 |
$394.08 |
| 90656 |
|
20 |
18 |
$390.93 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
25 |
24 |
$365.00 |
| 99384 |
|
14 |
14 |
$225.05 |
| 90670 |
|
24 |
24 |
$153.60 |
| 86580 |
|
26 |
26 |
$104.00 |
| 90715 |
|
12 |
12 |
$103.62 |
| 81025 |
|
17 |
12 |
$87.89 |
| 90651 |
|
16 |
12 |
$76.80 |