| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,425 |
3,713 |
$915K |
| H0002 |
Behavioral health screening to determine eligibility for admission to treatment program |
936 |
434 |
$198K |
| D0999 |
Unspecified diagnostic procedure, by report |
999 |
970 |
$140K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
737 |
657 |
$138K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
154 |
132 |
$32K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
132 |
118 |
$30K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
78 |
68 |
$17K |
| H0025 |
Behavioral health prevention education service (delivery of services with target population to affect knowledge, attitude and/or behavior) |
61 |
27 |
$14K |
| 90837 |
Psychotherapy, 53 minutes with patient |
64 |
27 |
$13K |
| D0191 |
|
54 |
45 |
$10K |
| 0012A |
|
128 |
126 |
$4K |
| D0190 |
|
247 |
194 |
$4K |
| D0145 |
Oral evaluation for a patient under three years of age |
47 |
42 |
$3K |
| 0011A |
|
142 |
140 |
$3K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
13 |
12 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
64 |
62 |
$2K |
| 0013A |
|
57 |
57 |
$2K |
| 0071A |
|
14 |
14 |
$638.29 |
| D1206 |
Topical application of fluoride varnish |
254 |
182 |
$523.98 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
137 |
54 |
$474.00 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
96 |
45 |
$237.00 |
| D1120 |
Prophylaxis - child |
33 |
33 |
$216.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
12 |
12 |
$211.97 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
323 |
314 |
$59.30 |
| 90461 |
|
77 |
72 |
$33.00 |
| 36415 |
Collection of venous blood by venipuncture |
1,168 |
1,006 |
$8.70 |
| 99000 |
|
2,127 |
1,861 |
$3.02 |
| 91300 |
|
26 |
25 |
$0.00 |
| 91301 |
|
371 |
354 |
$0.00 |
| 91307 |
|
25 |
19 |
$0.00 |