| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
6,579 |
5,368 |
$428K |
| 97803 |
|
9,125 |
9,115 |
$290K |
| G9920 |
Screening performed and negative |
8,602 |
8,529 |
$261K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
29,454 |
25,733 |
$233K |
| 96156 |
|
2,053 |
2,052 |
$209K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
4,792 |
4,789 |
$102K |
| D1206 |
Topical application of fluoride varnish |
3,869 |
3,837 |
$85K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
3,684 |
3,679 |
$80K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,657 |
1,640 |
$72K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
3,582 |
3,579 |
$68K |
| 90686 |
|
4,444 |
4,444 |
$49K |
| 99188 |
|
2,065 |
2,041 |
$45K |
| H0049 |
Alcohol and/or drug screening |
1,925 |
1,918 |
$39K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
2,735 |
2,719 |
$37K |
| 90651 |
|
2,279 |
2,270 |
$36K |
| 92552 |
|
9,461 |
9,438 |
$32K |
| V5008 |
Hearing screening |
1,148 |
1,145 |
$25K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,699 |
1,639 |
$25K |
| 90480 |
|
580 |
579 |
$23K |
| 99429 |
|
835 |
835 |
$20K |
| 96150 |
|
874 |
874 |
$19K |
| 90670 |
|
1,718 |
1,707 |
$19K |
| 90756 |
|
1,494 |
1,492 |
$16K |
| 0072A |
|
377 |
377 |
$15K |
| 0071A |
|
375 |
374 |
$15K |
| 90633 |
|
1,328 |
1,327 |
$14K |
| 90716 |
|
1,276 |
1,276 |
$14K |
| 90698 |
|
1,250 |
1,249 |
$13K |
| 0124A |
|
323 |
323 |
$13K |
| 90707 |
|
1,137 |
1,137 |
$12K |
| 90734 |
|
1,129 |
1,129 |
$12K |
| 97802 |
|
329 |
329 |
$12K |
| 90680 |
|
1,077 |
1,066 |
$12K |
| 90621 |
|
1,023 |
1,022 |
$11K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
201 |
200 |
$11K |
| 90674 |
|
954 |
950 |
$10K |
| 0154A |
|
220 |
220 |
$9K |
| 90744 |
|
753 |
746 |
$8K |
| 90715 |
|
718 |
718 |
$8K |
| 90688 |
|
616 |
616 |
$7K |
| 80061 |
Lipid panel |
2,365 |
2,362 |
$7K |
| 90685 |
|
546 |
544 |
$6K |
| 96127 |
|
1,012 |
1,003 |
$6K |
| 90697 |
|
251 |
251 |
$6K |
| 92551 |
|
1,101 |
1,098 |
$5K |
| 86480 |
|
362 |
362 |
$5K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
2,165 |
2,162 |
$4K |
| 0001A |
|
108 |
108 |
$4K |
| 90619 |
|
380 |
380 |
$4K |
| 0073A |
|
107 |
107 |
$4K |
| 0002A |
|
94 |
94 |
$4K |
| 0003A |
|
94 |
94 |
$4K |
| 0082A |
|
82 |
82 |
$3K |
| 0083A |
|
67 |
67 |
$3K |
| 0081A |
|
65 |
65 |
$3K |
| 90696 |
|
224 |
224 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
30 |
30 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
16,896 |
10,415 |
$2K |
| 99384 |
|
30 |
30 |
$2K |
| 91320 |
|
242 |
242 |
$2K |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
60 |
59 |
$2K |
| 83655 |
|
672 |
671 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
28 |
28 |
$2K |
| 99382 |
|
16 |
16 |
$2K |
| 90700 |
|
136 |
136 |
$1K |
| 86703 |
|
492 |
491 |
$1K |
| 90713 |
|
114 |
113 |
$1K |
| 87490 |
|
71 |
71 |
$740.76 |
| 3725F |
|
143 |
143 |
$715.00 |
| 99383 |
|
14 |
14 |
$570.10 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
2,471 |
2,467 |
$537.71 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
67 |
67 |
$512.82 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
67 |
67 |
$511.47 |
| 90648 |
|
46 |
46 |
$488.46 |
| 94664 |
|
42 |
40 |
$457.43 |
| 90677 |
|
39 |
39 |
$425.52 |
| 90672 |
|
29 |
29 |
$321.03 |
| 90671 |
|
14 |
14 |
$152.91 |
| 85013 |
|
669 |
668 |
$144.45 |
| 82947 |
|
177 |
177 |
$143.16 |
| 85018 |
|
644 |
643 |
$137.44 |
| 91318 |
|
65 |
65 |
$65.36 |
| 90461 |
|
2,851 |
2,291 |
$44.45 |
| 91319 |
|
199 |
199 |
$0.00 |