| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92553 |
|
93 |
93 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
234 |
231 |
$400.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
13 |
13 |
$61.79 |
| 94760 |
|
743 |
731 |
$8.76 |
| 82947 |
|
164 |
161 |
$6.54 |
| 1160F |
|
643 |
633 |
$0.00 |
| 1159F |
|
643 |
633 |
$0.00 |
| 3078F |
|
412 |
407 |
$0.00 |
| 1158F |
|
232 |
232 |
$0.00 |
| 94150 |
|
15 |
14 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
12 |
12 |
$0.00 |
| 3725F |
|
299 |
299 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
53 |
53 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
39 |
39 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
25 |
25 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
16 |
16 |
$0.00 |
| 3008F |
|
313 |
309 |
$0.00 |
| 3074F |
|
357 |
352 |
$0.00 |
| 3048F |
|
67 |
67 |
$0.00 |
| 1126F |
|
525 |
512 |
$0.00 |
| 1031F |
|
137 |
137 |
$0.00 |
| 3079F |
|
29 |
28 |
$0.00 |
| 92560 |
|
65 |
65 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
13 |
13 |
$0.00 |
| 1157F |
|
232 |
232 |
$0.00 |
| 3044F |
|
51 |
51 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
366 |
363 |
$0.00 |
| 1220F |
|
45 |
43 |
$0.00 |
| 1036F |
|
228 |
225 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
229 |
229 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
80 |
79 |
$0.00 |
| 81099 |
|
62 |
62 |
$0.00 |
| 3075F |
|
15 |
14 |
$0.00 |
| 81005 |
|
62 |
62 |
$0.00 |