| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,060 |
1,056 |
$42K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
576 |
574 |
$19K |
| 92552 |
|
1,154 |
1,144 |
$12K |
| 92081 |
|
1,081 |
1,071 |
$11K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,591 |
2,414 |
$3K |
| 90649 |
|
444 |
425 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
67 |
67 |
$2K |
| 90686 |
|
243 |
241 |
$2K |
| 90734 |
|
196 |
195 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,401 |
1,331 |
$1K |
| 90657 |
|
129 |
129 |
$1K |
| 90620 |
|
181 |
180 |
$1K |
| 90658 |
|
151 |
147 |
$1K |
| 90685 |
|
80 |
80 |
$793.60 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
13 |
13 |
$742.62 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,091 |
1,983 |
$452.05 |
| 90633 |
|
15 |
15 |
$141.75 |
| 86580 |
|
34 |
33 |
$92.50 |
| 90651 |
|
14 |
14 |
$79.36 |
| 92551 |
|
230 |
230 |
$44.08 |
| 99441 |
|
32 |
26 |
$0.00 |
| 99173 |
|
112 |
112 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
136 |
134 |
$0.00 |
| G9920 |
Screening performed and negative |
116 |
113 |
$0.00 |