| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
4,527 |
4,445 |
$79K |
| 97802 |
|
1,683 |
1,682 |
$61K |
| G9920 |
Screening performed and negative |
828 |
826 |
$29K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
8,343 |
7,496 |
$22K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
203 |
190 |
$15K |
| 99406 |
|
618 |
617 |
$8K |
| D1206 |
Topical application of fluoride varnish |
308 |
308 |
$7K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
728 |
715 |
$5K |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
187 |
187 |
$5K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
392 |
391 |
$5K |
| 99173 |
|
1,058 |
1,055 |
$4K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,502 |
1,446 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
226 |
221 |
$2K |
| 69210 |
|
36 |
36 |
$1K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
778 |
770 |
$1K |
| 99188 |
|
54 |
54 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,197 |
1,194 |
$548.21 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
902 |
901 |
$514.13 |
| 92552 |
|
1,739 |
1,733 |
$183.60 |
| 90651 |
|
353 |
351 |
$183.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
963 |
960 |
$89.74 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
12 |
12 |
$44.90 |
| 90686 |
|
1,667 |
1,665 |
$44.26 |
| 90670 |
|
395 |
395 |
$0.00 |
| 90715 |
|
62 |
60 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
110 |
110 |
$0.00 |
| 90734 |
|
128 |
128 |
$0.00 |
| 90710 |
|
29 |
29 |
$0.00 |
| 99382 |
|
53 |
53 |
$0.00 |
| 90685 |
|
19 |
18 |
$0.00 |
| 90700 |
|
12 |
12 |
$0.00 |
| 90633 |
|
105 |
104 |
$0.00 |
| 90619 |
|
73 |
73 |
$0.00 |
| 90698 |
|
52 |
52 |
$0.00 |
| 90680 |
|
13 |
13 |
$0.00 |
| 90688 |
|
117 |
117 |
$0.00 |
| 90656 |
|
132 |
132 |
$0.00 |
| 90620 |
|
12 |
12 |
$0.00 |
| 99383 |
|
80 |
80 |
$0.00 |
| 90696 |
|
13 |
13 |
$0.00 |