| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92551 |
|
3,480 |
3,466 |
$33K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,972 |
5,628 |
$17K |
| D1206 |
Topical application of fluoride varnish |
1,005 |
989 |
$16K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
431 |
426 |
$3K |
| 90686 |
|
651 |
649 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,397 |
1,275 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,268 |
1,264 |
$1K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,737 |
1,724 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
759 |
755 |
$815.85 |
| G9920 |
Screening performed and negative |
1,838 |
1,837 |
$696.00 |
| 90651 |
|
167 |
167 |
$600.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
447 |
443 |
$542.33 |
| 0071A |
|
12 |
12 |
$480.00 |
| 0072A |
|
12 |
12 |
$480.00 |
| 90734 |
|
130 |
128 |
$411.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
450 |
448 |
$360.34 |
| 90620 |
|
59 |
58 |
$258.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
844 |
843 |
$201.21 |
| 90648 |
|
101 |
101 |
$195.00 |
| 90670 |
|
103 |
103 |
$192.00 |
| 90723 |
|
65 |
65 |
$177.00 |
| 86580 |
|
100 |
96 |
$147.66 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
606 |
603 |
$107.95 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
94 |
94 |
$106.46 |
| 90715 |
|
25 |
25 |
$72.00 |
| 90633 |
|
82 |
82 |
$60.00 |
| 90716 |
|
44 |
44 |
$36.00 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
25 |
25 |
$24.75 |
| 90707 |
|
28 |
28 |
$24.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
65 |
65 |
$14.26 |
| 99173 |
|
2,971 |
2,959 |
$10.00 |
| 90461 |
|
428 |
420 |
$0.00 |
| 90700 |
|
12 |
12 |
$0.00 |
| H0049 |
Alcohol and/or drug screening |
245 |
244 |
$0.00 |
| 1036F |
|
766 |
765 |
$0.00 |