| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,518 |
2,028 |
$192K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,426 |
1,956 |
$165K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,852 |
1,690 |
$85K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,103 |
953 |
$81K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
890 |
822 |
$66K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
3,212 |
2,645 |
$61K |
| 90670 |
|
2,187 |
1,796 |
$38K |
| 96127 |
|
1,797 |
1,638 |
$27K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
302 |
272 |
$25K |
| 90686 |
|
1,783 |
1,536 |
$16K |
| 83655 |
|
1,087 |
884 |
$13K |
| 90698 |
|
1,133 |
944 |
$12K |
| 90633 |
|
1,113 |
932 |
$9K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
54 |
53 |
$8K |
| 90647 |
|
848 |
666 |
$8K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
564 |
535 |
$7K |
| 90723 |
|
776 |
609 |
$7K |
| 90681 |
|
469 |
412 |
$6K |
| 90744 |
|
608 |
521 |
$5K |
| 90680 |
|
584 |
458 |
$5K |
| 99381 |
|
49 |
47 |
$4K |
| 90651 |
|
180 |
159 |
$4K |
| D1206 |
Topical application of fluoride varnish |
127 |
103 |
$3K |
| 90716 |
|
200 |
172 |
$3K |
| 85018 |
|
1,014 |
822 |
$2K |
| 90707 |
|
173 |
150 |
$2K |
| 90656 |
|
83 |
80 |
$1K |
| 99215 |
Prolong outpt/office vis |
18 |
17 |
$1K |
| 90710 |
|
151 |
128 |
$1K |
| 99383 |
|
12 |
12 |
$966.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
116 |
101 |
$665.84 |
| 90696 |
|
86 |
66 |
$648.72 |
| 90685 |
|
70 |
56 |
$450.00 |
| 90700 |
|
56 |
44 |
$358.40 |
| 96160 |
|
26 |
25 |
$354.79 |
| 90677 |
|
19 |
19 |
$317.49 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
18 |
14 |
$275.50 |
| 36415 |
Collection of venous blood by venipuncture |
67 |
58 |
$217.30 |
| 90734 |
|
14 |
12 |
$89.60 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
28 |
27 |
$0.00 |
| 90461 |
|
16 |
16 |
$0.00 |