| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G9920 |
Screening performed and negative |
1,269 |
1,265 |
$28K |
| 97802 |
|
1,571 |
1,557 |
$18K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,780 |
1,763 |
$12K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
208 |
208 |
$10K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
159 |
158 |
$8K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
655 |
619 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,607 |
1,476 |
$3K |
| 0081A |
|
38 |
37 |
$720.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
55 |
55 |
$422.10 |
| 90461 |
|
72 |
72 |
$340.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
43 |
43 |
$55.68 |
| 99173 |
|
681 |
681 |
$0.00 |