| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
507 |
475 |
$297.60 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
328 |
316 |
$249.00 |
| 92552 |
|
28 |
28 |
$30.00 |
| 85018 |
|
258 |
257 |
$6.15 |
| 81005 |
|
189 |
187 |
$3.50 |
| 99173 |
|
280 |
279 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
78 |
77 |
$0.00 |
| 82465 |
|
152 |
150 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
223 |
219 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
174 |
106 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
78 |
78 |
$0.00 |
| 81007 |
|
12 |
12 |
$0.00 |
| 90461 |
|
13 |
12 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
78 |
77 |
$0.00 |
| 97803 |
|
45 |
45 |
$0.00 |
| 83026 |
|
13 |
13 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
22 |
22 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
145 |
144 |
$0.00 |
| 92551 |
|
201 |
200 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
805 |
749 |
$0.00 |
| 99000 |
|
335 |
327 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
53 |
53 |
$0.00 |