| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92551 |
|
840 |
840 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,110 |
2,090 |
$3K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
144 |
143 |
$2K |
| 88141 |
|
35 |
14 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
876 |
870 |
$305.61 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
332 |
327 |
$57.86 |
| 85018 |
|
971 |
971 |
$5.56 |
| 81002 |
|
157 |
157 |
$4.26 |
| 3074F |
|
2,873 |
2,830 |
$0.00 |
| 4010F |
|
1,280 |
1,273 |
$0.00 |
| 3008F |
|
5,924 |
5,852 |
$0.00 |
| 3075F |
|
366 |
365 |
$0.00 |
| 3351F |
|
4,666 |
4,620 |
$0.00 |
| 3014F |
|
577 |
571 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
843 |
838 |
$0.00 |
| 3061F |
|
952 |
946 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
44 |
44 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
377 |
377 |
$0.00 |
| 3079F |
|
179 |
175 |
$0.00 |
| 3044F |
|
203 |
202 |
$0.00 |
| H0049 |
Alcohol and/or drug screening |
384 |
380 |
$0.00 |
| 99385 |
|
41 |
41 |
$0.00 |
| H0001 |
Alcohol and/or drug assessment |
425 |
420 |
$0.00 |
| 90651 |
|
16 |
16 |
$0.00 |
| 3078F |
|
2,913 |
2,880 |
$0.00 |
| 99173 |
|
898 |
897 |
$0.00 |
| 3725F |
|
317 |
313 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
1,205 |
1,195 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
83 |
80 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
138 |
138 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
58 |
58 |
$0.00 |
| 3045F |
|
12 |
12 |
$0.00 |
| 90715 |
|
12 |
12 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
48 |
47 |
$0.00 |