| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G9920 |
Screening performed and negative |
4,469 |
4,460 |
$50K |
| 92551 |
|
2,998 |
2,988 |
$32K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
3,120 |
3,108 |
$27K |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
5,931 |
5,918 |
$24K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,730 |
1,728 |
$24K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,622 |
1,620 |
$18K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,131 |
1,128 |
$15K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,615 |
4,377 |
$11K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
616 |
610 |
$9K |
| 97802 |
|
5,121 |
5,114 |
$9K |
| 99401 |
|
5,704 |
5,694 |
$7K |
| 0071A |
|
160 |
160 |
$6K |
| 90686 |
|
3,085 |
3,073 |
$6K |
| 99188 |
|
1,578 |
1,576 |
$6K |
| 0124A |
|
108 |
108 |
$4K |
| 0072A |
|
100 |
100 |
$4K |
| 0001A |
|
128 |
99 |
$4K |
| 0002A |
|
80 |
79 |
$3K |
| 0003A |
|
62 |
62 |
$2K |
| 99173 |
|
2,580 |
2,578 |
$2K |
| 0111A |
|
54 |
54 |
$2K |
| 90685 |
|
124 |
119 |
$2K |
| D0120 |
Periodic oral evaluation - established patient |
4,782 |
4,775 |
$2K |
| 0154A |
|
43 |
43 |
$2K |
| 96111 |
|
844 |
841 |
$2K |
| 90647 |
|
635 |
629 |
$1K |
| 90707 |
|
464 |
463 |
$1K |
| 90660 |
|
1,598 |
1,597 |
$1K |
| 90670 |
|
646 |
637 |
$970.47 |
| 90633 |
|
540 |
539 |
$927.01 |
| 90651 |
|
690 |
686 |
$926.27 |
| 90723 |
|
367 |
362 |
$731.72 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
379 |
379 |
$637.29 |
| 90716 |
|
415 |
413 |
$617.65 |
| 0112A |
|
16 |
16 |
$600.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
62 |
59 |
$566.02 |
| 90734 |
|
510 |
510 |
$440.79 |
| 96127 |
|
110 |
110 |
$422.44 |
| 90680 |
|
209 |
205 |
$386.86 |
| D1206 |
Topical application of fluoride varnish |
66 |
66 |
$374.60 |
| 90480 |
|
66 |
66 |
$300.00 |
| 85018 |
|
146 |
141 |
$274.74 |
| 83655 |
|
13 |
13 |
$128.36 |
| 91321 |
|
29 |
29 |
$120.00 |
| 90656 |
|
118 |
118 |
$100.00 |
| 90744 |
|
12 |
12 |
$81.00 |
| 90715 |
|
53 |
53 |
$54.00 |
| 90696 |
|
40 |
40 |
$54.00 |
| 90672 |
|
177 |
177 |
$52.64 |
| 90671 |
|
28 |
28 |
$45.00 |
| 90697 |
|
24 |
24 |
$40.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
14 |
14 |
$31.77 |
| 90713 |
|
12 |
12 |
$27.00 |
| 90619 |
|
29 |
29 |
$27.00 |
| 96161 |
|
435 |
431 |
$22.04 |
| 90620 |
|
114 |
114 |
$9.00 |
| 90700 |
|
14 |
14 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
17 |
17 |
$0.00 |
| 91300 |
|
21 |
21 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
143 |
141 |
$0.00 |