| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
9,876 |
9,775 |
$125K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
7,506 |
7,019 |
$4K |
| D1206 |
Topical application of fluoride varnish |
87 |
87 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,104 |
2,026 |
$887.62 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
5,679 |
5,347 |
$736.38 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,035 |
1,031 |
$652.46 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
3,160 |
3,147 |
$40.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,880 |
1,867 |
$24.84 |
| 90744 |
|
113 |
113 |
$17.82 |
| 92551 |
|
10,102 |
10,076 |
$11.02 |
| 90698 |
|
1,007 |
1,004 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
3,284 |
3,204 |
$0.00 |
| H0049 |
Alcohol and/or drug screening |
934 |
924 |
$0.00 |
| 90716 |
|
42 |
42 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
755 |
746 |
$0.00 |
| 90651 |
|
1,336 |
1,335 |
$0.00 |
| 90686 |
|
2,733 |
2,731 |
$0.00 |
| 90696 |
|
179 |
178 |
$0.00 |
| 90619 |
|
538 |
533 |
$0.00 |
| 3008F |
|
22 |
22 |
$0.00 |
| 90680 |
|
117 |
117 |
$0.00 |
| 99383 |
|
13 |
13 |
$0.00 |
| 90656 |
|
56 |
56 |
$0.00 |
| 90657 |
|
15 |
15 |
$0.00 |
| 97802 |
|
330 |
330 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
4,248 |
4,241 |
$0.00 |
| 90715 |
|
328 |
328 |
$0.00 |
| 99173 |
|
9,736 |
9,707 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
3,868 |
3,860 |
$0.00 |
| 90621 |
|
1,113 |
1,108 |
$0.00 |
| 97803 |
|
3,336 |
3,274 |
$0.00 |
| 90734 |
|
759 |
759 |
$0.00 |
| 90670 |
|
866 |
866 |
$0.00 |
| G9919 |
Screening performed and positive and provision of recommendations |
305 |
301 |
$0.00 |
| G9920 |
Screening performed and negative |
1,932 |
1,913 |
$0.00 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
482 |
463 |
$0.00 |
| 99188 |
|
190 |
189 |
$0.00 |
| 90707 |
|
39 |
39 |
$0.00 |
| 90672 |
|
825 |
824 |
$0.00 |
| 90633 |
|
779 |
774 |
$0.00 |
| 90710 |
|
199 |
197 |
$0.00 |
| 90671 |
|
130 |
124 |
$0.00 |
| 81002 |
|
15 |
13 |
$0.00 |
| 99499 |
|
86 |
86 |
$0.00 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
12 |
12 |
$0.00 |
| 90700 |
|
12 |
12 |
$0.00 |