| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 96156 |
|
7,154 |
7,144 |
$382K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
3,694 |
3,675 |
$211K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
3,360 |
3,341 |
$159K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,619 |
5,297 |
$144K |
| G9920 |
Screening performed and negative |
5,566 |
5,558 |
$118K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,151 |
2,129 |
$89K |
| 92551 |
|
7,787 |
7,777 |
$84K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,590 |
3,437 |
$71K |
| 96151 |
|
2,101 |
2,090 |
$45K |
| 90686 |
|
4,008 |
4,003 |
$34K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
616 |
608 |
$25K |
| 85018 |
|
8,567 |
8,558 |
$20K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
319 |
319 |
$17K |
| 90651 |
|
1,220 |
1,219 |
$10K |
| 90672 |
|
1,204 |
1,204 |
$8K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
108 |
84 |
$8K |
| 90734 |
|
713 |
712 |
$7K |
| 90697 |
|
144 |
143 |
$5K |
| 90670 |
|
477 |
471 |
$5K |
| 90620 |
|
623 |
623 |
$4K |
| 92552 |
|
284 |
283 |
$4K |
| 0001A |
|
101 |
101 |
$4K |
| 90716 |
|
318 |
316 |
$3K |
| 90633 |
|
356 |
356 |
$3K |
| 90707 |
|
248 |
246 |
$2K |
| 0072A |
|
51 |
51 |
$2K |
| 90715 |
|
268 |
268 |
$2K |
| 0002A |
|
64 |
64 |
$2K |
| 0071A |
|
46 |
46 |
$2K |
| 90619 |
|
367 |
367 |
$1K |
| 81000 |
|
284 |
284 |
$1K |
| D1206 |
Topical application of fluoride varnish |
57 |
57 |
$1K |
| 99173 |
|
1,737 |
1,729 |
$921.26 |
| 90660 |
|
115 |
115 |
$864.00 |
| 90480 |
|
55 |
55 |
$836.00 |
| 90656 |
|
294 |
294 |
$684.00 |
| 90685 |
|
71 |
71 |
$653.30 |
| 81002 |
|
179 |
179 |
$646.45 |
| 96150 |
|
27 |
27 |
$622.79 |
| 90671 |
|
176 |
173 |
$492.75 |
| 90698 |
|
51 |
51 |
$489.23 |
| 0003A |
|
12 |
12 |
$480.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
62 |
62 |
$426.39 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
19 |
19 |
$335.75 |
| 90681 |
|
64 |
64 |
$270.00 |
| 90744 |
|
26 |
26 |
$257.67 |
| 86580 |
|
42 |
42 |
$173.13 |
| 83655 |
|
12 |
12 |
$137.46 |
| 90696 |
|
12 |
12 |
$108.00 |
| 90680 |
|
18 |
18 |
$108.00 |
| 96127 |
|
182 |
182 |
$11.01 |
| 94760 |
|
108 |
107 |
$0.00 |