| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G9920 |
Screening performed and negative |
2,020 |
2,014 |
$61K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,455 |
1,454 |
$60K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,711 |
1,709 |
$59K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,258 |
1,254 |
$38K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
2,538 |
2,518 |
$32K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
5,893 |
5,815 |
$30K |
| 92552 |
|
2,272 |
2,272 |
$27K |
| 92551 |
|
1,506 |
1,505 |
$8K |
| 99173 |
|
3,529 |
3,527 |
$7K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
177 |
177 |
$6K |
| 90686 |
|
1,239 |
1,237 |
$5K |
| 0072A |
|
102 |
102 |
$4K |
| 0071A |
|
102 |
102 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,440 |
5,693 |
$2K |
| 90480 |
|
60 |
60 |
$2K |
| 81002 |
|
1,183 |
1,182 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
26 |
26 |
$1K |
| 86580 |
|
317 |
313 |
$958.94 |
| 90700 |
|
259 |
257 |
$954.00 |
| 90670 |
|
208 |
208 |
$891.00 |
| 0154A |
|
14 |
14 |
$560.00 |
| 90651 |
|
256 |
256 |
$497.00 |
| 90633 |
|
110 |
110 |
$486.00 |
| 90716 |
|
85 |
84 |
$290.00 |
| 90648 |
|
79 |
79 |
$288.00 |
| 90707 |
|
80 |
80 |
$252.00 |
| 90734 |
|
109 |
109 |
$202.00 |
| 90713 |
|
82 |
81 |
$198.00 |
| 90680 |
|
38 |
38 |
$171.00 |
| 90473 |
|
24 |
24 |
$150.45 |
| 90621 |
|
82 |
82 |
$139.00 |
| 90474 |
|
38 |
38 |
$132.75 |
| 83655 |
|
13 |
13 |
$108.90 |
| 83026 |
|
90 |
90 |
$106.56 |
| 81000 |
|
40 |
40 |
$102.27 |
| 90685 |
|
12 |
12 |
$45.00 |
| 90688 |
|
12 |
12 |
$18.00 |
| 81001 |
|
84 |
84 |
$8.22 |
| 90657 |
|
423 |
423 |
$0.00 |
| 90672 |
|
26 |
26 |
$0.00 |
| 90655 |
|
13 |
13 |
$0.00 |