| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
34,772 |
24,437 |
$3.35M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
45,333 |
19,586 |
$513K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,822 |
1,084 |
$63K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,113 |
664 |
$38K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
850 |
538 |
$22K |
| 92081 |
|
2,023 |
2,016 |
$17K |
| G9920 |
Screening performed and negative |
750 |
613 |
$8K |
| 92551 |
|
1,994 |
1,982 |
$7K |
| 85014 |
|
1,151 |
1,139 |
$6K |
| 81005 |
|
1,495 |
1,470 |
$5K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
340 |
304 |
$4K |
| 90686 |
|
800 |
795 |
$4K |
| 97802 |
|
443 |
437 |
$3K |
| 96127 |
|
1,969 |
1,763 |
$3K |
| D1206 |
Topical application of fluoride varnish |
115 |
115 |
$2K |
| 90648 |
|
83 |
82 |
$764.46 |
| 90670 |
|
69 |
68 |
$645.21 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
26 |
14 |
$479.14 |
| 96111 |
|
14 |
14 |
$457.08 |
| 69210 |
|
24 |
24 |
$431.88 |
| 90700 |
|
43 |
43 |
$264.29 |
| 99188 |
|
47 |
47 |
$223.20 |
| 86580 |
|
31 |
30 |
$177.24 |
| 90633 |
|
25 |
25 |
$163.14 |
| 90651 |
|
82 |
82 |
$117.00 |
| 90734 |
|
55 |
54 |
$94.50 |
| 96156 |
|
659 |
654 |
$75.00 |
| 4037F |
|
110 |
109 |
$10.67 |
| 3008F |
|
602 |
580 |
$0.01 |
| 97803 |
|
319 |
318 |
$0.00 |
| 90707 |
|
27 |
27 |
$0.00 |
| 90713 |
|
13 |
13 |
$0.00 |
| 90715 |
|
13 |
13 |
$0.00 |
| 4274F |
|
14 |
14 |
$0.00 |
| 01 |
Inj., retisert, 0.01 mg |
320 |
198 |
$0.00 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
455 |
454 |
$0.00 |
| 90716 |
|
14 |
14 |
$0.00 |
| 90620 |
|
14 |
14 |
$0.00 |
| 90656 |
|
26 |
26 |
$0.00 |