| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,000 |
1,684 |
$133K |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
331 |
313 |
$20K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
406 |
386 |
$17K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
115 |
115 |
$12K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
105 |
103 |
$11K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
100 |
91 |
$9K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
76 |
66 |
$7K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
45 |
45 |
$4K |
| 99058 |
|
261 |
231 |
$4K |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
137 |
128 |
$4K |
| 92551 |
|
522 |
504 |
$4K |
| 81002 |
|
1,644 |
1,455 |
$3K |
| 93000 |
|
142 |
137 |
$2K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
80 |
77 |
$1K |
| 82962 |
|
545 |
456 |
$935.64 |
| 71046 |
Radiologic examination, chest; 2 views |
22 |
20 |
$592.92 |
| 81025 |
|
24 |
24 |
$149.67 |
| 3077F |
|
81 |
77 |
$0.00 |
| 3078F |
|
249 |
236 |
$0.00 |
| 90658 |
|
44 |
43 |
$0.00 |
| 1055F |
|
192 |
189 |
$0.00 |
| 3074F |
|
1,125 |
975 |
$0.00 |
| 3079F |
|
980 |
859 |
$0.00 |
| S9451 |
Exercise classes, non-physician provider, per session |
52 |
52 |
$0.00 |
| 3075F |
|
13 |
12 |
$0.00 |