| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,617 |
2,273 |
$69K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
893 |
859 |
$21K |
| G9920 |
Screening performed and negative |
787 |
759 |
$16K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,550 |
1,447 |
$9K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
999 |
492 |
$8K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
724 |
703 |
$8K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
458 |
447 |
$7K |
| 92587 |
|
287 |
287 |
$6K |
| 99223 |
Prolong inpt eval add15 m |
93 |
93 |
$6K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
552 |
496 |
$5K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
177 |
177 |
$4K |
| 92552 |
|
372 |
367 |
$4K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,097 |
1,972 |
$2K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
611 |
581 |
$2K |
| D1206 |
Topical application of fluoride varnish |
135 |
135 |
$2K |
| 90670 |
|
632 |
573 |
$1K |
| 99173 |
|
522 |
514 |
$1K |
| 90700 |
|
732 |
684 |
$1K |
| 99233 |
Prolong inpt eval add15 m |
34 |
28 |
$1K |
| 85018 |
|
910 |
892 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
60 |
60 |
$933.92 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
53 |
51 |
$863.24 |
| 90713 |
|
479 |
440 |
$772.94 |
| 90648 |
|
511 |
466 |
$734.08 |
| 90716 |
|
140 |
135 |
$677.92 |
| 90685 |
|
248 |
203 |
$512.27 |
| 99072 |
|
1,321 |
1,191 |
$474.52 |
| 90707 |
|
128 |
125 |
$425.52 |
| 92551 |
|
332 |
332 |
$336.16 |
| 81003 |
|
143 |
142 |
$307.52 |
| 90686 |
|
409 |
372 |
$298.98 |
| 90680 |
|
160 |
142 |
$259.24 |
| 90633 |
|
129 |
117 |
$162.12 |
| 90744 |
|
91 |
80 |
$103.05 |
| 96127 |
|
38 |
38 |
$40.39 |
| 90698 |
|
21 |
16 |
$36.00 |
| D0145 |
Oral evaluation for a patient under three years of age |
161 |
160 |
$30.00 |
| 90651 |
|
50 |
44 |
$9.00 |
| 90461 |
|
34 |
33 |
$0.00 |
| 90734 |
|
15 |
15 |
$0.00 |
| 90620 |
|
13 |
13 |
$0.00 |