| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 97802 |
|
3,683 |
3,668 |
$104K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
5,726 |
5,647 |
$94K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,077 |
1,976 |
$49K |
| 99188 |
|
1,902 |
1,892 |
$34K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,971 |
6,483 |
$31K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
545 |
378 |
$28K |
| 99173 |
|
4,286 |
4,273 |
$12K |
| 90697 |
|
328 |
327 |
$9K |
| 85018 |
|
5,120 |
5,069 |
$9K |
| D1206 |
Topical application of fluoride varnish |
381 |
365 |
$8K |
| 81001 |
|
2,853 |
2,837 |
$6K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,172 |
2,147 |
$5K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,876 |
1,875 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,523 |
1,517 |
$5K |
| 90680 |
|
943 |
924 |
$3K |
| 90670 |
|
1,329 |
1,320 |
$2K |
| 99460 |
|
28 |
28 |
$1K |
| 90698 |
|
576 |
557 |
$1K |
| 92551 |
|
4,369 |
4,355 |
$1K |
| 81000 |
|
330 |
330 |
$768.68 |
| 96127 |
|
162 |
162 |
$755.17 |
| 86580 |
|
261 |
260 |
$748.91 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
113 |
111 |
$605.16 |
| 90744 |
|
213 |
206 |
$596.25 |
| 99238 |
Hospital discharge day management, 30 minutes or less |
14 |
13 |
$567.03 |
| 90686 |
|
1,268 |
1,262 |
$491.73 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
18 |
18 |
$450.00 |
| 0072A |
|
12 |
12 |
$370.00 |
| 99381 |
|
12 |
12 |
$365.64 |
| 90651 |
|
334 |
334 |
$347.75 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
34 |
34 |
$292.02 |
| 90734 |
|
172 |
172 |
$196.66 |
| 90633 |
|
516 |
507 |
$183.02 |
| 87430 |
|
28 |
28 |
$179.96 |
| 90716 |
|
39 |
39 |
$131.08 |
| 90648 |
|
245 |
242 |
$130.50 |
| 90671 |
|
94 |
94 |
$126.00 |
| 90723 |
|
165 |
165 |
$112.50 |
| 90707 |
|
40 |
40 |
$100.40 |
| 90696 |
|
12 |
12 |
$9.00 |
| 90674 |
|
201 |
201 |
$9.00 |
| 90685 |
|
81 |
81 |
$9.00 |
| 90710 |
|
12 |
12 |
$9.00 |
| 90619 |
|
77 |
77 |
$0.00 |
| 90656 |
|
101 |
101 |
$0.00 |
| 90620 |
|
56 |
56 |
$0.00 |
| 99499 |
|
171 |
171 |
$0.00 |
| 90700 |
|
16 |
16 |
$0.00 |