| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,170 |
1,168 |
$18K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,609 |
1,512 |
$15K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
921 |
920 |
$15K |
| 90686 |
|
1,656 |
1,641 |
$6K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,972 |
1,842 |
$6K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,181 |
2,745 |
$6K |
| 92551 |
|
2,542 |
2,537 |
$6K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
109 |
104 |
$3K |
| 92552 |
|
132 |
132 |
$1K |
| 0071A |
|
27 |
27 |
$1K |
| 0072A |
|
22 |
22 |
$880.00 |
| 90461 |
|
881 |
454 |
$647.28 |
| 90651 |
|
72 |
72 |
$645.00 |
| 81000 |
|
843 |
841 |
$610.09 |
| 0073A |
|
15 |
15 |
$600.00 |
| 96156 |
|
145 |
145 |
$380.00 |
| 97802 |
|
159 |
159 |
$360.60 |
| 90685 |
|
75 |
70 |
$342.26 |
| 90700 |
|
75 |
74 |
$342.00 |
| 99173 |
|
133 |
132 |
$309.56 |
| 92499 |
|
608 |
605 |
$201.00 |
| 85018 |
|
358 |
353 |
$187.60 |
| 99384 |
|
13 |
12 |
$109.18 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
406 |
406 |
$102.16 |
| 90734 |
|
26 |
26 |
$54.00 |
| 90656 |
|
15 |
15 |
$45.00 |
| 81003 |
|
13 |
13 |
$33.54 |
| 83026 |
|
12 |
12 |
$32.40 |
| 90620 |
|
12 |
12 |
$27.00 |
| 90619 |
|
12 |
12 |
$19.00 |
| 99188 |
|
13 |
13 |
$17.82 |
| 90688 |
|
43 |
43 |
$9.00 |
| 86580 |
|
35 |
34 |
$0.00 |
| 96127 |
|
160 |
160 |
$0.00 |
| 81005 |
|
34 |
33 |
$0.00 |
| 90674 |
|
38 |
38 |
$0.00 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
631 |
631 |
$0.00 |
| 99442 |
|
13 |
13 |
$0.00 |
| 90655 |
|
38 |
38 |
$0.00 |
| 90658 |
|
38 |
38 |
$0.00 |
| 99446 |
|
13 |
13 |
$0.00 |
| 97803 |
|
50 |
48 |
$0.00 |