| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90658 |
|
424 |
421 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
10,636 |
9,770 |
$188.00 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
78 |
78 |
$79.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,248 |
1,238 |
$30.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
187 |
187 |
$15.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
34 |
33 |
$0.00 |
| 3077F |
|
778 |
753 |
$0.00 |
| 3078F |
|
843 |
825 |
$0.00 |
| 3015F |
|
336 |
330 |
$0.00 |
| 1158F |
|
1,093 |
1,073 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
59 |
59 |
$0.00 |
| 92081 |
|
1,086 |
1,085 |
$0.00 |
| 99401 |
|
95 |
93 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
793 |
454 |
$0.00 |
| 81025 |
|
294 |
286 |
$0.00 |
| 0502F |
|
92 |
80 |
$0.00 |
| 2022F |
|
29 |
27 |
$0.00 |
| 82948 |
|
173 |
170 |
$0.00 |
| 2024F |
|
60 |
60 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
42 |
42 |
$0.00 |
| 99408 |
|
42 |
41 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
13 |
13 |
$0.00 |
| 2028F |
|
29 |
29 |
$0.00 |
| 90715 |
|
16 |
16 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
25 |
25 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
40 |
40 |
$0.00 |
| 90633 |
|
13 |
13 |
$0.00 |
| 3074F |
|
491 |
481 |
$0.00 |
| 85018 |
|
827 |
815 |
$0.00 |
| 82962 |
|
329 |
318 |
$0.00 |
| 3351F |
|
1,792 |
1,764 |
$0.00 |
| 3075F |
|
301 |
300 |
$0.00 |
| 3014F |
|
140 |
136 |
$0.00 |
| 90657 |
|
21 |
21 |
$0.00 |
| 81000 |
|
798 |
660 |
$0.00 |
| 3079F |
|
624 |
617 |
$0.00 |
| 92250 |
|
128 |
128 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
318 |
314 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
493 |
491 |
$0.00 |
| 92551 |
|
349 |
347 |
$0.00 |
| 3017F |
|
435 |
431 |
$0.00 |
| 1036F |
|
178 |
164 |
$0.00 |
| 3080F |
|
73 |
72 |
$0.00 |
| 3072F |
|
76 |
70 |
$0.00 |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
59 |
54 |
$0.00 |
| 90651 |
|
13 |
13 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
24 |
24 |
$0.00 |
| 1000F |
|
12 |
12 |
$0.00 |
| 90688 |
|
16 |
16 |
$0.00 |
| 3008F |
|
46 |
45 |
$0.00 |
| 90686 |
|
42 |
42 |
$0.00 |