| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
159 |
159 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
114 |
114 |
$935.30 |
| 92551 |
|
38 |
38 |
$383.80 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
30 |
30 |
$173.55 |
| 85018 |
|
519 |
519 |
$142.10 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,118 |
1,969 |
$139.28 |
| 81000 |
|
278 |
277 |
$45.93 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
445 |
429 |
$32.40 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
487 |
476 |
$28.55 |
| 92552 |
|
364 |
364 |
$10.41 |
| 92081 |
|
265 |
265 |
$5.04 |
| 4245F |
|
271 |
268 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
130 |
130 |
$0.00 |
| 92060 |
|
13 |
13 |
$0.00 |
| 3008F |
|
272 |
269 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
47 |
47 |
$0.00 |
| 90686 |
|
48 |
48 |
$0.00 |
| 1220F |
|
56 |
56 |
$0.00 |
| 4037F |
|
65 |
65 |
$0.00 |
| 90651 |
|
54 |
54 |
$0.00 |
| 90688 |
|
14 |
14 |
$0.00 |
| 1038F |
|
14 |
14 |
$0.00 |
| 99173 |
|
84 |
84 |
$0.00 |
| 90734 |
|
27 |
27 |
$0.00 |
| 4124F |
|
13 |
13 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
57 |
57 |
$0.00 |
| 81002 |
|
80 |
80 |
$0.00 |
| 4035F |
|
56 |
56 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
38 |
38 |
$0.00 |
| 4025F |
|
36 |
36 |
$0.00 |