| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
8,090 |
8,050 |
$50K |
| D1206 |
Topical application of fluoride varnish |
2,568 |
1,897 |
$21K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
17,814 |
16,915 |
$5K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
610 |
608 |
$940.51 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,908 |
2,903 |
$900.90 |
| 97802 |
|
9,681 |
9,397 |
$536.35 |
| 97803 |
|
3,038 |
2,968 |
$530.28 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
2,638 |
2,632 |
$448.71 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
614 |
606 |
$295.59 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
2,093 |
2,028 |
$237.22 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,944 |
1,940 |
$193.05 |
| 90686 |
|
1,848 |
1,842 |
$52.98 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,364 |
1,329 |
$44.55 |
| 99383 |
|
13 |
13 |
$39.60 |
| 99188 |
|
609 |
606 |
$19.60 |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
33 |
32 |
$16.33 |
| 92551 |
|
9,198 |
9,182 |
$11.02 |
| G9920 |
Screening performed and negative |
7,589 |
7,559 |
$0.00 |
| 99173 |
|
8,913 |
8,895 |
$0.00 |
| 98960 |
|
8,841 |
8,604 |
$0.00 |
| 4004F |
|
1,889 |
1,886 |
$0.00 |
| 1003F |
|
6,811 |
6,805 |
$0.00 |
| 2014F |
|
1,283 |
1,281 |
$0.00 |
| 90710 |
|
313 |
313 |
$0.00 |
| 90633 |
|
220 |
220 |
$0.00 |
| 90670 |
|
392 |
392 |
$0.00 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
946 |
932 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
792 |
790 |
$0.00 |
| 90621 |
|
137 |
133 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
90 |
90 |
$0.00 |
| 90734 |
|
170 |
169 |
$0.00 |
| 90715 |
|
98 |
98 |
$0.00 |
| 99499 |
|
75 |
73 |
$0.00 |
| 83655 |
|
41 |
41 |
$0.00 |
| 90685 |
|
37 |
37 |
$0.00 |
| 0071A |
|
64 |
64 |
$0.00 |
| 90672 |
|
99 |
98 |
$0.00 |
| 81002 |
|
18 |
18 |
$0.00 |
| 90473 |
|
16 |
16 |
$0.00 |
| 1000F |
|
7,976 |
7,947 |
$0.00 |
| 99000 |
|
407 |
401 |
$0.00 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
4,128 |
3,986 |
$0.00 |
| 96156 |
|
8,188 |
8,171 |
$0.00 |
| H0049 |
Alcohol and/or drug screening |
881 |
858 |
$0.00 |
| 90651 |
|
674 |
673 |
$0.00 |
| 96151 |
|
391 |
391 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
198 |
197 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
2,455 |
2,427 |
$0.00 |
| 90619 |
|
158 |
157 |
$0.00 |
| 90696 |
|
82 |
82 |
$0.00 |
| 90698 |
|
58 |
58 |
$0.00 |
| 0072A |
|
66 |
66 |
$0.00 |
| 90620 |
|
24 |
24 |
$0.00 |
| 90744 |
|
41 |
41 |
$0.00 |
| 90677 |
|
27 |
27 |
$0.00 |
| 90697 |
|
31 |
31 |
$0.00 |
| H0001 |
Alcohol and/or drug assessment |
12 |
12 |
$0.00 |
| 90656 |
|
25 |
25 |
$0.00 |
| 91307 |
|
14 |
14 |
$0.00 |