| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92551 |
|
2,947 |
2,928 |
$32K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,804 |
4,439 |
$26K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,287 |
1,222 |
$9K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
359 |
359 |
$9K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,596 |
1,529 |
$8K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
811 |
775 |
$6K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
222 |
216 |
$5K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
619 |
600 |
$5K |
| G9920 |
Screening performed and negative |
2,984 |
2,926 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
531 |
496 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
205 |
199 |
$2K |
| 99462 |
|
52 |
42 |
$1K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
841 |
834 |
$1K |
| 99460 |
|
25 |
25 |
$1K |
| 99188 |
|
348 |
348 |
$694.98 |
| 99383 |
|
41 |
41 |
$379.96 |
| 90688 |
|
13 |
13 |
$231.92 |
| 99384 |
|
25 |
25 |
$130.24 |
| 99173 |
|
200 |
196 |
$121.42 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
181 |
180 |
$0.00 |
| 84436 |
|
166 |
165 |
$0.00 |
| 80053 |
Comprehensive metabolic panel |
173 |
172 |
$0.00 |
| 1036F |
|
2,562 |
2,322 |
$0.00 |
| 1000F |
|
2,490 |
2,302 |
$0.00 |
| 81001 |
|
188 |
185 |
$0.00 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
13 |
13 |
$0.00 |
| 84443 |
Thyroid stimulating hormone (TSH) |
171 |
170 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
242 |
238 |
$0.00 |
| 3351F |
|
13 |
13 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
287 |
282 |
$0.00 |
| 80061 |
Lipid panel |
169 |
168 |
$0.00 |
| 83655 |
|
98 |
97 |
$0.00 |
| 90461 |
|
224 |
221 |
$0.00 |