| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 96156 |
|
4,833 |
4,828 |
$140K |
| 99404 |
|
9,158 |
9,070 |
$137K |
| 90651 |
|
1,284 |
1,277 |
$87K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
12,207 |
11,246 |
$48K |
| 90674 |
|
617 |
617 |
$13K |
| 0071A |
|
248 |
248 |
$10K |
| 0072A |
|
245 |
245 |
$10K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,183 |
2,159 |
$8K |
| 0001A |
|
188 |
188 |
$7K |
| 90688 |
|
363 |
363 |
$7K |
| 0002A |
|
187 |
187 |
$6K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
612 |
589 |
$6K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
2,858 |
2,835 |
$4K |
| 92551 |
|
6,530 |
6,517 |
$3K |
| 90670 |
|
885 |
876 |
$3K |
| 0003A |
|
64 |
64 |
$3K |
| 90686 |
|
2,539 |
2,536 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,289 |
2,234 |
$2K |
| 90648 |
|
916 |
907 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
2,639 |
2,624 |
$2K |
| 90723 |
|
299 |
294 |
$1K |
| 90685 |
|
171 |
159 |
$1K |
| 0073A |
|
27 |
27 |
$1K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
160 |
160 |
$703.83 |
| 0053A |
|
12 |
12 |
$480.00 |
| 90620 |
|
52 |
52 |
$450.00 |
| 96127 |
|
1,767 |
1,753 |
$429.41 |
| 90734 |
|
1,235 |
1,229 |
$405.00 |
| 92552 |
|
158 |
138 |
$280.84 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
916 |
881 |
$217.15 |
| 99000 |
|
1,804 |
1,768 |
$180.42 |
| 90461 |
|
328 |
312 |
$150.00 |
| 90710 |
|
347 |
341 |
$126.00 |
| 90715 |
|
355 |
354 |
$120.00 |
| 85018 |
|
1,718 |
1,702 |
$96.19 |
| 90633 |
|
427 |
422 |
$96.00 |
| 90680 |
|
89 |
89 |
$78.00 |
| 99173 |
|
6,138 |
6,122 |
$77.88 |
| 96160 |
|
4,887 |
4,879 |
$70.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
329 |
320 |
$53.52 |
| 99441 |
|
16 |
15 |
$18.75 |
| 36415 |
Collection of venous blood by venipuncture |
1,438 |
1,425 |
$11.26 |
| 94150 |
|
165 |
157 |
$11.14 |
| 90696 |
|
26 |
26 |
$9.00 |
| 94664 |
|
110 |
108 |
$8.60 |
| 81003 |
|
100 |
96 |
$5.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
487 |
484 |
$0.03 |
| 3078F |
|
121 |
111 |
$0.00 |
| G9920 |
Screening performed and negative |
608 |
608 |
$0.00 |
| 99442 |
|
95 |
93 |
$0.00 |
| G8511 |
Screening for depression documented as positive, follow-up plan not documented, reason not given |
52 |
52 |
$0.00 |
| 1000F |
|
136 |
136 |
$0.00 |
| 94760 |
|
364 |
344 |
$0.00 |
| 36416 |
|
385 |
383 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
70 |
70 |
$0.00 |
| 3074F |
|
113 |
103 |
$0.00 |