| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
12,226 |
10,128 |
$1.41M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
15,515 |
12,038 |
$1.35M |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
2,562 |
2,558 |
$379K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
6,285 |
6,088 |
$205K |
| 92552 |
|
4,456 |
4,451 |
$176K |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
4,521 |
3,957 |
$130K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,423 |
1,421 |
$97K |
| 94760 |
|
18,700 |
15,554 |
$70K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
777 |
776 |
$47K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
553 |
553 |
$34K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
719 |
718 |
$34K |
| D1206 |
Topical application of fluoride varnish |
1,755 |
1,660 |
$31K |
| G0438 |
Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit |
132 |
132 |
$26K |
| 90651 |
|
525 |
523 |
$12K |
| 99072 |
|
1,203 |
1,040 |
$11K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
269 |
267 |
$11K |
| 90670 |
|
230 |
226 |
$9K |
| 69210 |
|
172 |
163 |
$9K |
| 99215 |
Prolong outpt/office vis |
34 |
25 |
$7K |
| 99188 |
|
209 |
202 |
$4K |
| G0444 |
Annual depression screening, 5 to 15 minutes |
117 |
117 |
$2K |
| 90734 |
|
427 |
427 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
13 |
13 |
$2K |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
56 |
56 |
$1K |
| 90656 |
|
3,157 |
3,147 |
$1K |
| 90710 |
|
100 |
98 |
$1K |
| 0072A |
|
45 |
45 |
$798.50 |
| 96127 |
|
120 |
117 |
$738.12 |
| 90633 |
|
250 |
248 |
$717.50 |
| 99383 |
|
16 |
16 |
$713.82 |
| 90744 |
|
82 |
82 |
$705.78 |
| 96160 |
|
190 |
190 |
$673.16 |
| 0071A |
|
39 |
39 |
$659.25 |
| 90715 |
|
82 |
82 |
$562.48 |
| 90698 |
|
118 |
115 |
$520.00 |
| 90716 |
|
31 |
31 |
$455.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
33 |
33 |
$400.95 |
| 90696 |
|
12 |
12 |
$382.50 |
| 99408 |
|
13 |
13 |
$374.88 |
| 99406 |
|
13 |
13 |
$227.37 |
| 90707 |
|
26 |
26 |
$220.00 |
| 99173 |
|
223 |
223 |
$29.79 |
| 90655 |
|
78 |
78 |
$20.00 |
| 91307 |
|
214 |
168 |
$0.00 |
| 91305 |
|
121 |
102 |
$0.00 |
| 0001A |
|
19 |
19 |
$0.00 |
| 90713 |
|
12 |
12 |
$0.00 |
| 90700 |
|
29 |
29 |
$0.00 |
| 91300 |
|
43 |
43 |
$0.00 |
| 90621 |
|
41 |
41 |
$0.00 |
| 0002A |
|
24 |
24 |
$0.00 |
| 99401 |
|
65 |
63 |
$0.00 |